| Marty K Sanner Md Pc | |
|
4202 Sw Lee Blvd Bldg A Suite 104 Lawton OK 73505 | |
| (580) 353-7777 | |
| (580) 248-8313 |
| Full Name | Marty K Sanner Md Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 4202 Sw Lee Blvd, Lawton, Oklahoma |
| Authorized Official Name and Position | Marty K Sanner (PRESIDENT OWNER) |
| Authorized Official Contact | 5803537777 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Marty K Sanner Md Pc 4202 Sw Lee Blvd Bldg A Suite 104 Lawton OK 73505 Ph: (580) 353-7777 | Marty K Sanner Md Pc 4202 Sw Lee Blvd Bldg A Suite 104 Lawton OK 73505 Ph: (580) 353-7777 |
| NPI Number | 1679758866 |
|---|---|
| Provider Enumeration Date | 01/07/2008 |
| Last Update Date | 08/27/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679758866 | NPI | - | NPPES |
| 100101130D | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 18448 (Oklahoma) | Primary |
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