Provider Demographics
NPI:1407884935
Name:MEARS, MARTIN A (DC)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:A
Last Name:MEARS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2620 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-6709
Mailing Address - Country:US
Mailing Address - Phone:405-348-2226
Mailing Address - Fax:405-348-3357
Practice Address - Street 1:2620 E 2ND ST
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-6709
Practice Address - Country:US
Practice Address - Phone:405-348-2226
Practice Address - Fax:405-348-3357
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1781111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKT75158Medicare UPIN
OKQDBWCMedicare PIN