| Doctor Name: | MR. THOMAS ELIOT MARTIN |
| NPI Number: | 1356414643 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | RN, MSN, ACNP |
| License Number: | RN71531 |
| Business Practice Address: | 122 N Bailey St Pryor, OK - 743614202 |
| Business Phone Number: | 9188250216 |
| Business Fax Number: | 9188250216 |
| Mailing Address: | 122 N Bailey St, PRYOR |
| State: | OK |
| Postal Code: | 743614202 |
| Phone Number: | 9188250216 |
| Fax Number: | 9188250216 |
| NPI Enumeration Date: | 11/16/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2100X |
| License Number: | RN71531 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Acute Care |
| Taxonomy Definition: | |