Organization
MARTIN J LOPEZ MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARTIN J LOPEZ MD (PRESIDENT/OWNER)
(405) 631-0300
Entity
Organization
Contact information
Practice address
4525 S KLEIN AVE, STE 900, OKLAHOMA CITY, OK 73109-3845
(405) 631-0300
(405) 631-0371
Mailing address
PO BOX 1772, NORMAN, OK 73070-1772
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
16998
OK
207LP2900X
Pain Medicine (Anesthesiology) Physician
16998
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050032793
RAILROAD MEDICARE
OK
05
—
100746810A
—
OK
01
—
441702842001
BCBS OF OK
OK
01
—
4460958
AETNA
OK
Enumeration date
10/13/2005
Last updated
07/12/2022
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