Organization
MARTIN PODIATRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL H MARTIN DPM (OWNER)
(580) 402-2146
Entity
Organization
Contact information
Practice address
2501 N VAN BUREN ST, ENID, OK 73703-1711
(580) 402-2146
(405) 285-8921
Mailing address
PO BOX 8584, EDMOND, OK 73083-8584
(580) 402-2146
(405) 285-8921
Taxonomy
Speciality
Code
Description
License number
State
261QP1100X
Podiatric Clinic/Center
Primary
117
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100780400A
—
OK
Enumeration date
09/19/2017
Last updated
09/19/2017
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