Provider Demographics
NPI:1942009626
Name:MARTIN, JAMES JAY (CP)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:JAY
Last Name:MARTIN
Suffix:
Gender:M
Credentials:CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5300 N SHARTEL AVE UNIT 18187
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73154-4606
Mailing Address - Country:US
Mailing Address - Phone:405-850-2069
Mailing Address - Fax:
Practice Address - Street 1:220 SE 4TH ST STE 400
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73129-1002
Practice Address - Country:US
Practice Address - Phone:405-850-2069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist