Provider Demographics
NPI:1831288695
Name:MARTIN, WILLIAM HOBART ALFORD (DO)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:HOBART ALFORD
Last Name:MARTIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1168
Mailing Address - Street 2:
Mailing Address - City:TALIHINA
Mailing Address - State:OK
Mailing Address - Zip Code:74571-1168
Mailing Address - Country:US
Mailing Address - Phone:918-567-2251
Mailing Address - Fax:918-567-4151
Practice Address - Street 1:END OF HIGHWAY 63A
Practice Address - Street 2:
Practice Address - City:TALIHINA
Practice Address - State:OK
Practice Address - Zip Code:74571-1168
Practice Address - Country:US
Practice Address - Phone:918-567-2251
Practice Address - Fax:918-567-4151
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK2291207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKEO9729Medicare UPIN