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Individual

MARINN RANK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
2345 SOUTHWEST BLVD, TULSA, OK 74107-2705
(918) 582-1980
(918) 561-1289
Mailing address
2401 SOUTHWEST BLVD, TULSA, OK 74107-2726
(918) 561-5701
(918) 561-1173

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5616
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200570460A
OK
01
607735YMSD
MEDICARE
OK
Enumeration date
03/11/2013
Last updated
04/06/2020
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