Carr, Leland

Carr, Leland is an sole proprietor health care provider with primary practice located at 1001 N Grand Ave , Tahlequah OK 74464-7017. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Carr, Leland can be contacted via phone (918) 458-2109.

Contact Information

Primary practice address
1001 N Grand Ave Tahlequah OK 74464-7017
Fax: (918) 458-2310
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 1102 Oklahoma

Profile Details

NPI number 1891786778
LBN Legal business name Carr, Leland
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 31st, 2005
Last updated Jan 6th, 2012 - about 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891786778 NPPES
Oklahoma MEDICAID 200081250A

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