Healthcare Provider Details

I. General information

NPI: 1306808928
Provider Name (Legal Business Name): MARTHA M TARPAY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2006
Last Update Date: 10/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 W MEMORIAL RD SUITE 206
OKLAHOMA CITY OK
73120-9350
US

IV. Provider business mailing address

4200 W MEMORIAL RD SUITE 206
OKLAHOMA CITY OK
73120-9350
US

V. Phone/Fax

Practice location:
  • Phone: 405-752-0393
  • Fax: 405-752-4242
Mailing address:
  • Phone: 405-752-0393
  • Fax: 405-752-4242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number10144
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: