Carlisle, Max L
Carlisle, Max L is an individual health care provider with primary practice located at 111 E Broadway , Fairview OK 73737-2124. He recently has 7 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Low Vision Rehabilitation, Eye and Vision Services Providers / Pediatrics, Eye and Vision Services Providers / Sports Vision, Eye and Vision Services Providers / Vision Therapy, Eye and Vision Services Providers / Occupational Vision. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Carlisle, Max L can be contacted via phone (580) 227-4878.Contact Information
Primary practice address
111 E Broadway
Fairview OK 73737-2124
Phone: (580) 227-4878
Fax: (580) 227-4666
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 973 | Oklahoma |
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | 973 | Oklahoma |
| Eye and Vision Services Providers / Low Vision Rehabilitation | 152WL0500X | 973 | Oklahoma |
| Eye and Vision Services Providers / Pediatrics | 152WP0200X | 973 | Oklahoma |
| Eye and Vision Services Providers / Sports Vision | 152WS0006X | 973 | Oklahoma |
| Eye and Vision Services Providers / Vision Therapy | 152WV0400X | 973 | Oklahoma |
| Eye and Vision Services Providers / Occupational Vision | 152WX0102X | 973 | Oklahoma |
Profile Details
| NPI number | 1205839685 |
|---|---|
| LBN Legal business name | Carlisle, Max L |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 31st, 2005 |
| Last updated | Dec 23rd, 2013 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1205839685 | NPPES |
| Oklahoma | Other | 0246290001 | PALMETTO DMERC |
| Oklahoma | MEDICAID | 100766110A | PALMETTO DMERC |
| Oklahoma | Other | 410046324 | PALMETTO DMERC |
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