Provider Demographics
NPI:1679571129
Name:MARTIN, RAYMOND S III (MD)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:S
Last Name:MARTIN
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:356 24TH AVE N
Mailing Address - Street 2:SUITE 300
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1514
Mailing Address - Country:US
Mailing Address - Phone:615-292-5722
Mailing Address - Fax:615-346-6225
Practice Address - Street 1:4230 HARDING RD
Practice Address - Street 2:SUITE 525
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2013
Practice Address - Country:US
Practice Address - Phone:615-385-1547
Practice Address - Fax:615-297-9161
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2011-09-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TNTN18058208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3027039Medicaid
TN3027039Medicare PIN
TN3027039Medicaid
TN30270351Medicare PIN