Organization
GLENPOOL FAMILY CLINIC A PROF CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL CRAIG MARTIN D.O. (OWNER AND OPERATOR)
(918) 322-9510
Entity
Organization
Contact information
Practice address
14226 SO ELM, GLENPOOL, OK 74033-3525
(918) 322-9510
(918) 322-9753
Mailing address
14226 SO ELM, GLENPOOL, OK 74033-1029
(918) 322-9510
(918) 322-9753
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2180
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000004050A
—
OK
Enumeration date
03/13/2007
Last updated
05/27/2009
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