Individual
MATTHEW TYLER MARR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4509 INTEGRIS PKWY STE 300, EDMOND, OK 73034-8696
(405) 657-3704
(405) 657-3892
Mailing address
3001 QUAIL SPRINGS PKWY FL 5, OKLAHOMA CITY, OK 73134-2640
(405) 657-3704
(405) 657-3892
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
34899
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1619395175
—
ME
Enumeration date
04/02/2014
Last updated
08/13/2024
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