Healthcare Provider Details

I. General information

NPI: 1932016987
Provider Name (Legal Business Name): BUFFALO PRIMARY CARE AND WALK IN CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 E WADE WATTS AVE
MCALESTER OK
74501-5655
US

IV. Provider business mailing address

74 CHOC LN
MCALESTER OK
74501-7288
US

V. Phone/Fax

Practice location:
  • Phone: 918-233-6522
  • Fax:
Mailing address:
  • Phone: 918-841-5120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: HANNAH MARIE MARTIN
Title or Position: PROVIDER
Credential: APRN
Phone: 918-841-5120