Provider Demographics
NPI:1992972277
Name:MARTIN, KIMBERLY CLAIRE (DO)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:CLAIRE
Last Name:MARTIN
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:PO BOX 268838
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73126-8838
Mailing Address - Country:US
Mailing Address - Phone:918-619-8700
Mailing Address - Fax:918-634-7884
Practice Address - Street 1:591 E 36TH ST N
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74106-1812
Practice Address - Country:US
Practice Address - Phone:918-619-4400
Practice Address - Fax:918-634-7884
Is Sole Proprietor?:No
Enumeration Date:2008-05-15
Last Update Date:2015-09-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK57742080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200596340AMedicaid