Provider Demographics
NPI:1770846172
Name:MARTIN, DANIEL ALLEN (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:ALLEN
Last Name:MARTIN
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Gender:M
Credentials:PHYSICIAN ASSISTANT
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Mailing Address - Street 1:331 SIJEN AVE
Mailing Address - Street 2:
Mailing Address - City:WHITEMAN AFB
Mailing Address - State:MO
Mailing Address - Zip Code:65305-1269
Mailing Address - Country:US
Mailing Address - Phone:405-626-0333
Mailing Address - Fax:
Practice Address - Street 1:331 SIJAN AVENUE
Practice Address - Street 2:
Practice Address - City:WHITEMAN AFB
Practice Address - State:MO
Practice Address - Zip Code:65305-1269
Practice Address - Country:US
Practice Address - Phone:405-626-0333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-20
Last Update Date:2021-12-15
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant