Individual
DR. DENNIS LEE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
912 W CEDAR ST, STILWELL, OK 74960-3406
(918) 696-7278
(918) 696-7280
Mailing address
912 W CEDAR ST, STILWELL, OK 74960-3406
(918) 696-7278
(918) 696-7280
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11948
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100093670A
—
OK
01
—
731084309001
BLUE CROSS/BLUE SHIELD
OK
Enumeration date
08/13/2006
Last updated
07/08/2007
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