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General NPI Number Information
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NPI Number | 1699764225
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Entity Type | Individual
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Provider Name | ROBERT MONROE MARTIN III PH.D.
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Gender | Male
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Dates
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Enumeration Date | 10/17/2005
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Last Update Date | 04/06/2020
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Provider Practice Location Address
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Address Line | 2417 WESTPORT DR
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City | NORMAN
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State | OK
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Zip | 73069-6337
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Country | US
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Telephone | 405-579-7560
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Fax | 405-579-7563
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Provider Business Mailing Address
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Address Line | 712 WALL ST STE 100
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City | NORMAN
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State | OK
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Zip | 73069-6360
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Country | US
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Telephone | 405-579-7560
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Fax | 405-579-7563
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 926
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 1539
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License Number State | OK
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