Provider Demographics
NPI:1659031979
Name:TARVER, MARTIN LUKE (PA-C)
Entity Type:Individual
Prefix:
First Name:MARTIN
Middle Name:LUKE
Last Name:TARVER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2898
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79604-2898
Mailing Address - Country:US
Mailing Address - Phone:325-677-2201
Mailing Address - Fax:325-677-7641
Practice Address - Street 1:401 CYPRESS ST STE 110
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-5122
Practice Address - Country:US
Practice Address - Phone:325-677-2201
Practice Address - Fax:325-677-7641
Is Sole Proprietor?:No
Enumeration Date:2021-12-28
Last Update Date:2021-12-28
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant