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Individual

JOSEPH MOODY MARTIN JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP

Contact information

Practice address
1 MEDICAL PARK BLVD, BRISTOL, TN 37620-7430
(423) 282-1480
(423) 928-1353
Mailing address
PO BOX 4018, JOHNSON CITY, TN 37602-4018
(423) 282-1480
(423) 928-1353

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
15877
TN

Other

Enumeration date
08/12/2011
Last updated
12/11/2017
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