Glenpool Family Clinic a Prof Corp

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2180 Issued in OK

Legal business name

GLENPOOL FAMILY CLINIC A PROF CORP

Practice address

14226 So Elm
Glenpool, OK 74033-3525

Phone

(918) 322-9510

Fax

(918) 322-9753

NPI assigned

Mar 13, 2007

Last updated

May 27, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Daniel Craig Martin, D.O.

Title

Owner and Operator

Phone

(918) 322-9510

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243382400000",
    "number": "1003949694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14226 SO ELM",
            "city": "GLENPOOL",
            "state": "OK",
            "postal_code": "740331029",
            "telephone_number": "918-322-9510",
            "fax_number": "918-322-9753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14226 SO ELM",
            "city": "GLENPOOL",
            "state": "OK",
            "postal_code": "740333525",
            "telephone_number": "918-322-9510",
            "fax_number": "918-322-9753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENPOOL FAMILY CLINIC A PROF CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2009-05-27",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "CRAIG",
        "authorized_official_title_or_position": "OWNER AND OPERATOR",
        "authorized_official_telephone_number": "918-322-9510",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "2180",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000004050A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Genscripts Glenpool, LLC (Genscripts Pharmacy)
• Chase Gerety, DDS
• Sarah Elizabeth Gilmore, DDS
• Glennwood Healthcare Inc
• Glenpool Eye Care, PLLC
• Glenpool Health Services LLC
• Glenpool Operations LLC (Glennwood Healthcare)
• Glenpool Pain Management LLC (Glenpool Pain Management)
• Glenpool Pharmacy Inc (Medicap Pharmacy)
• Glenpool Public Schools

• Family Medicine Physician in Glenpool, OK
• Providers in Glenpool, OK by specialty
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.