# MARY WADE MARTIN MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316224058
- **Authorized official:** MARY WADE MARTIN MD (PHYSICIAN/OWNER)
- **Authorized official phone:** (405) 936-0504

## Contact information

- **Practice address:** 608 NW 9TH ST, SUITE 5010, OKLAHOMA CITY, OK 73102-1068
- **Practice address phone:** (405) 272-7026
- **Practice address fax:** (405) 272-7027
- **Mailing address:** 608 NW 9TH ST, SUITE 5010, OKLAHOMA CITY, OK 73102-1068
- **Mailing address phone:** (405) 272-7026
- **Mailing address fax:** (405) 272-7027

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 23664 | OK | Yes |

## Other

- **Enumeration date:** 11/09/2011
- **Last updated:** 10/26/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200016330A | — | OK |