Individual
JEFFREY D MARTENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
3100 SW 89TH ST, OKLAHOMA CITY, OK 73159-7900
(405) 602-8390
(405) 602-8391
Mailing address
3330 NW 56TH ST, STE 206, OKLAHOMA CITY, OK 73112-4426
(405) 602-8390
(405) 602-8391
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
704
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100132310A,B,C
—
OK
Enumeration date
05/31/2005
Last updated
03/01/2014
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