Individual
GARY L MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3500 E FRANK PHILLIPS BLVD, JPMC ANESTHESIA DEPT, BARTLESVILLE, OK 74006-2411
(918) 331-1555
(918) 331-1695
Mailing address
PO BOX 3456, BARTLESVILLE, OK 74006-3456
(918) 333-3830
(918) 333-3846
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R0030164
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100788020A
—
OK
Enumeration date
09/14/2006
Last updated
10/27/2009
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