Individual
JONATHAN MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
211 BLOUNT AVE, SUITE 507, KNOXVILLE, TN 37920
(865) 525-0598
(865) 525-0598
Mailing address
PO BOX 779, JOHNSON CITY, TN 37605-0779
(423) 928-1145
(423) 928-1353
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
37585
TN
208M00000X
Hospitalist Physician
37585
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3886502
—
TN
01
—
4066540
BCBS
TN
01
—
7688492
AETNA
TN
01
—
P00078148
PALMETTO GBA-RR MCR
TN
Enumeration date
01/04/2006
Last updated
08/03/2020
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