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General NPI Number Information
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NPI Number | 1376619866
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Entity Type | Individual
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Provider Name | JOHN CHRISTOPHER MARTIN MD
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Gender | Male
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Dates
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Enumeration Date | 11/27/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 105 S BRYANT AVE SUITE 300
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City | EDMOND
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State | OK
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Zip | 73034-6399
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Country | US
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Telephone | 405-348-9070
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Fax | 405-359-6919
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Provider Business Mailing Address
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Address Line | 105 S BRYANT AVE. SUITE 300
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City | EDMOND
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State | OK
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Zip | 73034
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Country | US
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Telephone | 405-348-9070
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Fax | 405-359-6919
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 12465
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License Number State | OK
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