Martin, Ricardo S

Martin, Ricardo S is an individual health care provider with primary practice located at 401 E Main St , Johnson City TN 37601-4877. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Martin, Ricardo S can be contacted via phone (423) 722-2057.

Contact Information

Primary practice address
401 E Main St Johnson City TN 37601-4877
Fax: (423) 542-5109
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 07269 Tennessee

Profile Details

NPI number 1831199868
LBN Legal business name Martin, Ricardo S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 1st, 2005
Last updated Jul 8th, 2007 - about 17 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 1831199868 NPPES
Tennessee MEDICAID 3150742

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