Provider Demographics
NPI:1457637142
Name:BUCHANAN, MARTHA RUTH
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:RUTH
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 N.E. 13TH ST
Mailing Address - Street 2:P.O. BOX 53277
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73152-3277
Mailing Address - Country:US
Mailing Address - Phone:405-522-8020
Mailing Address - Fax:405-522-6809
Practice Address - Street 1:1200 NE 13TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73117-1022
Practice Address - Country:US
Practice Address - Phone:405-522-8020
Practice Address - Fax:405-522-6809
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-26
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management