Provider Demographics
NPI:1982639175
Name:MARTIN, JAMES A (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:A
Last Name:MARTIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 3146
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46206-3146
Mailing Address - Country:US
Mailing Address - Phone:855-206-8406
Mailing Address - Fax:855-823-8132
Practice Address - Street 1:1710 GUNBARREL RD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-3127
Practice Address - Country:US
Practice Address - Phone:423-553-1220
Practice Address - Fax:423-553-1231
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN244382085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN300107647OtherRR MCARE-CI
AL009918800Medicaid
TN300107970OtherRR MCARE-ADR
TN3146630OtherPLAZA BC/BS OF TN
GA000867798Medicaid
TN4017577OtherADR BC/BS OF TN
TNG55828Medicare UPIN
AL009918800Medicaid
GA000867798Medicaid
TN3817010Medicare PIN
TN3146630OtherPLAZA BC/BS OF TN