Provider Demographics
NPI:1134181720
Name:MARTIN, CAROLE KATHLEEN (DC)
Entity type:Individual
Prefix:DR
First Name:CAROLE
Middle Name:KATHLEEN
Last Name:MARTIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 STADIUM DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-3591
Mailing Address - Country:US
Mailing Address - Phone:615-824-1474
Mailing Address - Fax:615-824-4019
Practice Address - Street 1:117 STADIUM DR
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-3503
Practice Address - Country:US
Practice Address - Phone:615-824-1474
Practice Address - Fax:615-824-4019
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-06
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1990111N00000X, 111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4111979Medicaid
TN3973686Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
TNU94077Medicare UPIN