Provider Demographics
NPI:1366570145
Name:DAVIS, MARTIN JEFFERSON (DO)
Entity type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:JEFFERSON
Last Name:DAVIS
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:8136 S MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-4309
Mailing Address - Country:US
Mailing Address - Phone:918-461-2441
Mailing Address - Fax:918-461-2469
Practice Address - Street 1:8136 S MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-4309
Practice Address - Country:US
Practice Address - Phone:918-461-2441
Practice Address - Fax:918-461-2469
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2025-05-25
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Provider Licenses
StateLicense IDTaxonomies
OK2516207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKOK404231Medicare PIN
OKE09650Medicare UPIN