Provider Demographics
NPI:1215269642
Name:MARTIN K. JONES, MD INC.
Entity type:Organization
Organization Name:MARTIN K. JONES, MD INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:K
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:580-248-2229
Mailing Address - Street 1:1002 SW 52ND ST
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-7840
Mailing Address - Country:US
Mailing Address - Phone:580-248-2229
Mailing Address - Fax:580-248-2208
Practice Address - Street 1:1002 SW 52ND ST
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-7840
Practice Address - Country:US
Practice Address - Phone:580-248-2229
Practice Address - Fax:580-248-2208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-10
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK14827207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100113030AMedicaid
OK100113030AMedicaid
OK444621786MMedicare PIN