Provider Demographics
NPI:1568492460
Name:MARTIN AND ASSOCIATES MEDICAL AND SURGICAL CENTER PC
Entity Type:Organization
Organization Name:MARTIN AND ASSOCIATES MEDICAL AND SURGICAL CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TIM
Authorized Official - Middle Name:
Authorized Official - Last Name:KLEMME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-792-7640
Mailing Address - Street 1:321 E 3RD ST N
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:IA
Mailing Address - Zip Code:50208-3210
Mailing Address - Country:US
Mailing Address - Phone:641-792-7640
Mailing Address - Fax:641-792-4029
Practice Address - Street 1:321 E 3RD ST N
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:IA
Practice Address - Zip Code:50208-3210
Practice Address - Country:US
Practice Address - Phone:641-792-7640
Practice Address - Fax:641-792-4029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAI18563Medicare PIN