person
Vince Russell Martin, PA
Medical Physician Assistant in Sallisaw, Oklahoma
NPI 1942329636

Vince Russell Martin is a Medical Physician Assistant based in Sallisaw, OK and is specialized in Medical. Vince Russell Martin practices in Sallisaw, OK and has the professional credentials of PA. The NPI Number for Vince Russell Martin is 1942329636 and holds a License No. 1514 (Oklahoma).

The current practice location address for Vince Russell Martin is 700 W Cherokee Ave, Sallisaw, OK and can be reached out via phone at 918-775-0007 and via fax at 918-775-8910.

Location: 700 W Cherokee Ave, Sallisaw, OK, 74955-4216
person
Provider Profile Details
NPI Number
1942329636
Provider Name
Vince Russell Martin
Credential
PA
Provider Entity Type
Individual
Gender
Male
Address
700 W Cherokee Ave, Sallisaw, OK, 74955-4216
Phone Number
918-775-0007
Fax Number
918-775-8910
Provider Enumeration Date
03/27/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1514 01 OK OKLAHOMA LICENSE
34366 01 OK OK BUR OF NARCOTICS & DD
institution
Provider Business Practice Location Address Details
Address
700 W Cherokee Ave
City
State
Zip
74955-4216
Phone Number
918-775-0007
Fax Number
918-775-8910
person
Provider Business Mailing Address Details
Address
700 W Cherokee Ave
City
State
Zip
74955-4216
Phone Number
918-775-0007
Fax Number
918-775-8910
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
1514 (Oklahoma)
Definition
Definition to come...
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