Organization
MARY WADE MARTIN MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY WADE MARTIN MD (PHYSICIAN/OWNER)
(405) 936-0504
Entity
Organization
Contact information
Practice address
608 NW 9TH ST, SUITE 5010, OKLAHOMA CITY, OK 73102-1068
(405) 272-7026
(405) 272-7027
Mailing address
608 NW 9TH ST, SUITE 5010, OKLAHOMA CITY, OK 73102-1068
(405) 272-7026
(405) 272-7027
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
23664
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200016330A
—
OK
Enumeration date
11/09/2011
Last updated
10/26/2012
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