Provider Demographics
NPI:1972699429
Name:MARTIN, HEATHER BELFORD (MD)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:BELFORD
Last Name:MARTIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:BELFORD
Other - Last Name:SUMMERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6565 S YALE AVE
Mailing Address - Street 2:SUITE 610
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-8307
Mailing Address - Country:US
Mailing Address - Phone:918-502-2200
Mailing Address - Fax:918-502-2210
Practice Address - Street 1:6565 S YALE AVE
Practice Address - Street 2:SUITE 610
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-8307
Practice Address - Country:US
Practice Address - Phone:918-502-2200
Practice Address - Fax:918-502-2210
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK22434207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200013830AMedicaid
OKH89642Medicare UPIN
243329307Medicare PIN