Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | MD26883 | TN |
NPI | 1245225424 |
---|---|
Provider Name | Dr. David Allen Martin |
First Address | Knoxville, TN 37932-3330 |
Second Address | Knoxville, TN 37932-3330 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2005 |
Last Update Date | 03/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C85333 | (02) | TN |
Q020272 | (05) | TN |