Individual
DEAN ERWIN MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
550 S PEORIA AVE, TULSA, OK 74120-3820
(918) 588-1900
(918) 382-1242
Mailing address
550 S PEORIA AVE, TULSA, OK 74120-3820
(918) 588-1900
(918) 382-1242
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
13789
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100123800-A
—
OK
01
—
100732910
MEDICAID/SOONERCARE GROUP #
OK
01
—
73-1042545
TRICARE GROUP #
OK
Enumeration date
08/01/2006
Last updated
06/16/2015
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