Provider Demographics
NPI:1679670608
Name:MARTIN, JOSEPH E (PHARM D)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:E
Last Name:MARTIN
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 182
Mailing Address - Street 2:
Mailing Address - City:RICKMAN
Mailing Address - State:TN
Mailing Address - Zip Code:38580-0182
Mailing Address - Country:US
Mailing Address - Phone:931-498-5484
Mailing Address - Fax:931-823-5313
Practice Address - Street 1:1075 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:TN
Practice Address - Zip Code:38570-1741
Practice Address - Country:US
Practice Address - Phone:931-823-5539
Practice Address - Fax:931-823-5313
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8873183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist