Individual
BENJAMIN MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1921 STONECIPHER BLVD, ADA, OK 74820
(580) 421-4570
(580) 421-6283
Mailing address
1921 STONECIPHER BLVD, ADA, OK 74820
(580) 421-4570
(580) 421-6283
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A130881
CA
Other
Enumeration date
11/26/2014
Last updated
09/08/2016
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