Marty K Sanner MD PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

18448 Issued in OK

Legal business name

MARTY K SANNER MD PC

Practice address

4202 SW Lee Blvd
BLDG a Suite 104
Lawton, OK 73505

Phone

(580) 353-7777

Fax

(580) 248-8313

NPI assigned

Jan 7, 2008

Last updated

Aug 27, 2008By 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

Marty K Sanner, MDNPI 1831183037

Title

President Owner

Phone

(580) 353-7777

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Marty Kelly Sanner, MD

  • Internal Medicine Physician
  • Lawton, OK
  • NPI 1831183037
  Authorized official Same address or phone

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

{
    "created_epoch": "1199664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219795200000",
    "number": "1679758866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4202 SW LEE BLVD",
            "address_2": "BLDG A SUITE 104",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "73505",
            "telephone_number": "580-353-7777",
            "fax_number": "580-248-8313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4202 SW LEE BLVD",
            "address_2": "BLDG A SUITE 104",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "73505",
            "telephone_number": "580-353-7777",
            "fax_number": "580-248-8313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTY K SANNER MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-07",
        "last_updated": "2008-08-27",
        "status": "A",
        "authorized_official_last_name": "SANNER",
        "authorized_official_first_name": "MARTY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "580-353-7777",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "18448",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100101130D",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lacie Danielle Martinez
• Michelle Renee Martinez, SLPA
• Samantha Martinez, RDN, LD
• Lauryn Marton
• Oksana I Martsinkevich, DO
• Madyson Marvulli
• Rejina Marie Marziale
• Isacc Jermayne Mason
• Kristie Marie Mason, MD
• Victoria Mason

• Internal Medicine Physician in Lawton, OK
• Providers in Lawton, OK by specialty
• Internal Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2008; 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.