Provider Demographics
NPI:1083732333
Name:FELKER, MARTHA (MED)
Entity Type:Individual
Prefix:MRS
First Name:MARTHA
Middle Name:
Last Name:FELKER
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1139 WOODRIDGE PL
Mailing Address - Street 2:
Mailing Address - City:MOUNT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-4510
Mailing Address - Country:US
Mailing Address - Phone:615-310-6151
Mailing Address - Fax:615-288-4943
Practice Address - Street 1:1139 WOODRIDGE PL
Practice Address - Street 2:
Practice Address - City:MOUNT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-4510
Practice Address - Country:US
Practice Address - Phone:615-310-6151
Practice Address - Fax:615-288-7478
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist