Provider Demographics
NPI:1750718730
Name:STAMAR MEDICAL PLC
Entity type:Organization
Organization Name:STAMAR MEDICAL PLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:918-284-6642
Mailing Address - Street 1:550 W 125TH PL S STE 200
Mailing Address - Street 2:
Mailing Address - City:GLENPOOL
Mailing Address - State:OK
Mailing Address - Zip Code:74033-5026
Mailing Address - Country:US
Mailing Address - Phone:918-224-7305
Mailing Address - Fax:918-518-5730
Practice Address - Street 1:550 W 125TH PL S STE 200
Practice Address - Street 2:
Practice Address - City:GLENPOOL
Practice Address - State:OK
Practice Address - Zip Code:74033-5026
Practice Address - Country:US
Practice Address - Phone:918-224-7305
Practice Address - Fax:918-518-5730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-04
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3218207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty