Organization
MICHAEL L MARTIN PH D PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL L MARTIN PH.D. (OWNER)
(918) 619-7337
Entity
Organization
Contact information
Practice address
5555 E 71ST ST, TULSA, OK 74136-6542
(918) 895-6294
(918) 895-6295
Mailing address
5555 E 71ST ST, TULSA, OK 74136-6542
(918) 895-6294
(918) 895-6295
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
764
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100840240A
—
OK
Enumeration date
02/18/2017
Last updated
02/18/2017
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