Provider Demographics
NPI:1467454108
Name:MARTIN, HENRY FRANK (MD)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:FRANK
Last Name:MARTIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1211 UNION AVE
Mailing Address - Street 2:SUITE 975
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-6638
Mailing Address - Country:US
Mailing Address - Phone:901-725-0347
Mailing Address - Fax:901-725-5359
Practice Address - Street 1:1211 UNION AVE
Practice Address - Street 2:SUITE 975
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-6638
Practice Address - Country:US
Practice Address - Phone:901-725-0347
Practice Address - Fax:901-725-5359
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN10811207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TND32091Medicare UPIN