Martin, Frederick A

Martin, Frederick A is an sole proprietor health care provider with primary practice located at 1958 W State St , Bristol TN 37620-1940. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Martin, Frederick A can be contacted via phone (423) 574-7575.

Contact Information

Primary practice address
1958 W State St Bristol TN 37620-1940
Fax: (423) 574-7576
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD35685 Tennessee

Profile Details

NPI number 1164417713
LBN Legal business name Martin, Frederick A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 20th, 2005
Last updated May 31st, 2016 - about 8 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 1164417713 NPPES
Virginia MEDICAID 010178835
Virginia Other 4107515
Virginia Other 62172092012
Virginia MEDICAID 3707101
Virginia Other 179765
Virginia Other 4338099

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