Individual
DR. MARTIN J LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4525 S KLEIN AVE, STE 900, OKLAHOMA CITY, OK 73109-3845
(405) 636-1797
Mailing address
PO BOX 99730, OKLAHOMA CITY, OK 73199-0001
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
16998
OK
207LP2900X
Pain Medicine (Anesthesiology) Physician
16998
OK
208VP0014X
Interventional Pain Medicine Physician
Primary
16998
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050032793
RAILROAD MEDICARE
OK
05
—
100096400A
—
OK
01
—
4460958
AETNA
OK
Enumeration date
10/13/2005
Last updated
01/07/2020
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