Provider Demographics
NPI:1225157720
Name:MARTINEZ, JOSE B (PA)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:B
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:720 COOL SPRINGS BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-2626
Mailing Address - Country:US
Mailing Address - Phone:615-778-4066
Mailing Address - Fax:615-778-9114
Practice Address - Street 1:720 SAINT MICHAELS DR
Practice Address - Street 2:SUITE 2B, C, F
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-7600
Practice Address - Country:US
Practice Address - Phone:615-778-4066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NM76PA004363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant