Individual
MICHAEL MARTINDALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
616 W FOREST AVE, JACKSON, TN 38301-3902
(731) 422-0435
(731) 422-0478
Mailing address
PO BOX 400, JACKSON, TN 38302-0400
(731) 423-8697
(731) 422-5743
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD20281
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3067754
—
TN
Enumeration date
03/09/2006
Last updated
06/27/2014
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