Individual
DR. MIKE P MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1 CHOCTAW WAY, TALIHINA, OK 74571-2022
(918) 567-7019
Mailing address
PO BOX 151, TALIHINA, OK 74571-0151
(918) 563-4239
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
143
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1499419
—
OK
Enumeration date
05/02/2006
Last updated
11/07/2011
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