Active NPI
Mark R. Martin, D.PH
- Pharmacist
- Pryor, OK
National Provider Identifier
1689734097
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 13412
- Practice address
- 510 S Elliott St
Pryor, OK 74361-6411 - Phone
- (918) 825-2225
- Fax
- (918) 825-0972
- NPI assigned
- Dec 8, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 13412 | OK | Primary |
Addresses
Primary practice location
510 S Elliott St
Pryor, OK 74361-6411
Mailing address
1035 Covey LN
Locust Grove, OK 74352-7307
Phone (918) 521-5756
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13412 | OK | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1689734097",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1035 COVEY LN",
"city": "LOCUST GROVE",
"state": "OK",
"postal_code": "743527307",
"telephone_number": "918-521-5756"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "510 S ELLIOTT ST",
"city": "PRYOR",
"state": "OK",
"postal_code": "743616411",
"telephone_number": "918-825-2225",
"fax_number": "918-825-0972"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "MARK",
"middle_name": "R.",
"credential": "D.PH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OK",
"license": "13412",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pryor, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.