Martin, Shannon L

Martin, Shannon L is an individual health care provider with primary practice located at 3 E Clark Bass Blvd Suite 2, Mcalester OK 74501. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Martin, Shannon L can be contacted via phone (918) 421-6960.

Contact Information

Primary practice address
3 E Clark Bass Blvd Suite 2 Mcalester OK 74501
Phone: (918) 421-6960
Fax: (918) 421-6963
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 2298 Oklahoma
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA03391 Texas
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA03391 Texas

Profile Details

NPI number 1427080399
LBN Legal business name Martin, Shannon L
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2006
Last updated Jan 23rd, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427080399 NPPES
Texas MEDICAID 358865905
Texas Other 8JM949
Texas Other 8JM948
Texas Other 667700
Texas Other P02056995
Texas Other P02057001
Texas MEDICAID 358865904

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