Individual
RICARDO S MARTIN JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
401 E MAIN ST, JOHNSON CITY, TN 37601-4877
(423) 722-2057
(423) 542-5109
Mailing address
401 E MAIN ST, JOHNSON CITY, TN 37601-4877
(423) 722-2057
(423) 542-5109
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
07269
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3150742
—
TN
Enumeration date
08/01/2005
Last updated
07/08/2007
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