Healthcare Provider Details

I. General information

NPI: 1871646901
Provider Name (Legal Business Name): MARTIN K. OAKS PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 W OKLAHOMA AVE
MILWAUKEE WI
53215-4330
US

IV. Provider business mailing address

W176S8582 NATURE CT
MUSKEGO WI
53150-8599
US

V. Phone/Fax

Practice location:
  • Phone: 414-649-7825
  • Fax:
Mailing address:
  • Phone: 262-679-4502
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170100000X
TaxonomyPh.D. Medical Genetics
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: