Provider Demographics
NPI:1043394661
Name:JARSHAW, MARTIN L (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:L
Last Name:JARSHAW
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
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Mailing Address - Street 1:4401 WILD PLUM LN
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73003-2983
Mailing Address - Country:US
Mailing Address - Phone:405-270-0501
Mailing Address - Fax:405-290-1815
Practice Address - Street 1:921 NE 13TH ST
Practice Address - Street 2:119
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5007
Practice Address - Country:US
Practice Address - Phone:405-270-0501
Practice Address - Fax:405-290-1815
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH013515183500000X
FLPS 18377183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered183500000XPharmacy Service ProvidersPharmacist