| Doctor Name: | DR. MIKE P MARTIN |
| NPI Number: | 1639137516 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPM |
| License Number: | 143 |
| Business Practice Address: | 1 Choctaw Way Talihina, OK - 745712022 |
| Business Phone Number: | 9185677019 |
| Business Fax Number: | |
| Mailing Address: | Po Box 151, TALIHINA |
| State: | OK |
| Postal Code: | 745710151 |
| Phone Number: | 9185634239 |
| Fax Number: | |
| NPI Enumeration Date: | 05/02/2006 |
| NPI Last Update Date: | 11/07/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213EP1101X |
| License Number: | 143 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MT |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Primary Podiatric Medicine |
| Taxonomy Definition: | |