Organization
MARTY K SANNER MD PC
Active
Organization
MARTY K SANNER MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTY K SANNER MD (PRESIDENT OWNER)
(580) 353-7777
Entity
Organization
Contact information
Practice address
4202 SW LEE BLVD, BLDG A SUITE 104, LAWTON, OK 73505
(580) 353-7777
(580) 248-8313
Mailing address
4202 SW LEE BLVD, BLDG A SUITE 104, LAWTON, OK 73505
(580) 353-7777
(580) 248-8313
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
18448
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100101130D
—
OK
Enumeration date
01/07/2008
Last updated
08/27/2008
Update your record
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