Tom Pearce Martin, M.D.
Individual provider Active NPI Emergency Care Clinic/Center · Junction, IL
NPI 1083875751 · NPPES record last updated Jun 24, 2008
Key facts
- NPI
- 1083875751
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Care Clinic/Center 261QE0002X
- License
- 036-049331 (IL)
- Practice address
- 10900 Porter LN
Junction, IL 62954-2200 - Phone
- (618) 269-4034
- NPI assigned
- Jun 24, 2008
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-049331 | IL | MD | Emergency Care Clinic/Center |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Care Clinic/Center | 261QE0002X | 036-049331 | IL | Yes |
Addresses
Primary practice location
10900 Porter LN
Junction, IL 62954-2200
Mailing address
10900 Porter LN
Junction, IL 62954-2200
Other providers in Junction, IL
All providers in Junction, IL · Emergency Care Clinic/Center in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 24, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.