Provider Demographics
NPI:1649212598
Name:MARTIN, JASON B (MD)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:B
Last Name:MARTIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 WOODMONT BLVD
Mailing Address - Street 2:SUITE LL50
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-2245
Mailing Address - Country:US
Mailing Address - Phone:615-386-2361
Mailing Address - Fax:615-386-2399
Practice Address - Street 1:4230 HARDING PIKE
Practice Address - Street 2:SUITE 400
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2013
Practice Address - Country:US
Practice Address - Phone:615-297-2700
Practice Address - Fax:615-386-2399
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH093449207RC0200X, 207RP1001X
TN38713207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN6008922OtherBCBST
P00395865OtherRAILROAD MEDICARE
TN3333497Medicaid
KY6411903500Medicaid
TN103I113888Medicare PIN
TN6008922OtherBCBST
P00395865OtherRAILROAD MEDICARE
TNP01371931Medicare PIN