Martin, Vince Russell

Martin, Vince Russell is an individual health care provider with primary practice located at 700 W Cherokee Ave , Sallisaw OK 74955-4216. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Martin, Vince Russell can be contacted via phone (918) 775-0007.

Contact Information

Primary practice address
700 W Cherokee Ave Sallisaw OK 74955-4216
Phone: (918) 775-0007
Fax: (918) 775-8910
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 1514 Oklahoma

Profile Details

NPI number 1942329636
LBN Legal business name Martin, Vince Russell
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 27th, 2007
Last updated Mar 7th, 2023 - about 3 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 1942329636 NPPES
Oklahoma Other 1514 OKLAHOMA LICENSE
Oklahoma Other 34366 OKLAHOMA LICENSE

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