Provider Demographics
NPI:1073836235
Name:MARTINEZ, CURTIS CEASAR (PA)
Entity Type:Individual
Prefix:MR
First Name:CURTIS
Middle Name:CEASAR
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:201 E WILL ROGERS BLVD
Mailing Address - Street 2:
Mailing Address - City:CLAREMORE
Mailing Address - State:OK
Mailing Address - Zip Code:74017-7452
Mailing Address - Country:US
Mailing Address - Phone:918-341-8100
Mailing Address - Fax:918-341-8139
Practice Address - Street 1:201 E WILL ROGERS BLVD
Practice Address - Street 2:
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74017-7452
Practice Address - Country:US
Practice Address - Phone:918-341-8100
Practice Address - Fax:918-341-8139
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-02
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKAPA1775363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant