Individual
DR. AMANDA DEANN MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2004 HAYES ST STE 200, NASHVILLE, TN 37203-2689
(615) 324-1600
(615) 324-1661
Mailing address
101 ROCKEFELLER DR, SUITE 101, MUSKOGEE, OK 74401-5056
(918) 684-2663
(918) 681-6804
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
5695
OK
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
2782
TN
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
5695
OK
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
DO1125
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134324825
—
AL
05
—
200583770A
—
OK
Enumeration date
06/20/2007
Last updated
02/11/2021
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