John Bruce Martin is a Clinical in Evanston, Illinois. John Bruce Martin practices all healthcare services and medical treatments related to Clinical. The NPI Number for John Bruce Martin is 1619962727. The last update date is 2007-07-08.
John Bruce Martin's current location address is 838 Michigan Ave, Evanston, Illinois. You can contact this provider via phone number 8478691392 and fax number 8478691392. The mailing address for John Bruce Martin is 838 Michigan Ave, Evanston, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | John Bruce Martin |
|---|---|
| Address | 838 Michigan Ave, Evanston, Illinois |
| Phone Number | 8478691392 |
| Fax Number | 8478691392 |
| Sole Proprietor | N |
| Credentials | PH.D |
NPI Number Detail
| NPI Number | 1619962727 |
|---|---|
| Provider Enumeration Date | 2005-09-14 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 838 Michigan Ave |
|---|---|
| City | Evanston |
| State | Illinois (IL) |
| Post Code | 602022591 |
| Phone Number | 8478691392 |
| Fax Number | 8478691392 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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What is the unique 10-digit identifier code issued to John Bruce Martin by the Centers for Medicare & Medicaid Services?
The John Bruce Martin has been assigned the NPI (National Provider Identifier) 1619962727 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Can you provide the John Bruce Martin's physical address?
The John Bruce Martin is physically located at 838 Michigan Ave, in the city of Evanston, IL, with the postal code 602022591.
What is John Bruce Martin's specialized field of practice, and what is the corresponding taxonomy classification code?
The John Bruce Martin's area of specialization is Clinical, and the corresponding taxonomy code that categorizes this field of practice is 103Tc0700X.
On what date was the 1619962727 assigned to John Bruce Martin?
The John Bruce Martin was issued its 1619962727 on 2005-09-14, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the John Bruce Martin's details last updated?
The information pertaining to the John Bruce Martin, including its address, specialty, and other details, was most recently updated on 2007-07-08.
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