Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 404 | TN |
NPI | 1255329264 |
---|---|
Provider Name | Mr. Martin Lyle Toy |
First Address | Smyrna, TN 37167 |
Second Address | Smyrna, TN 37167 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2005 |
Last Update Date | 28/05/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T87027 | (02) | TN |