Cleveland, Martin Ervin

Cleveland, Martin Ervin is an individual health care provider with primary practice located at Blanchfield Army Community Hospital 650 Joel Drive, Bldg E, Fort Campbell KY 42223-5349. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Cleveland, Martin Ervin can be contacted via phone (270) 798-4097.

Contact Information

Primary practice address
Blanchfield Army Community Hospital 650 Joel Drive, Bldg E Fort Campbell KY 42223-5349
Phone: (270) 798-4097
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X P 1078 Tennessee

Profile Details

NPI number 1275632242
LBN Legal business name Cleveland, Martin Ervin
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 22nd, 2006
Last updated Jun 21st, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275632242 NPPES
Tennessee MEDICAID 36822411
Tennessee Other 4141240

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