Coburn, Jerry K
Coburn, Jerry K is an individual health care provider with primary practice located at 742 N York St , Muskogee OK 74403-3866. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Coburn, Jerry K can be contacted via phone (918) 682-7752.Contact Information
Primary practice address
742 N York St
Muskogee OK 74403-3866
Phone: (918) 682-7752
Fax: (918) 687-8440
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 956 | Oklahoma |
Profile Details
| NPI number | 1083681159 |
|---|---|
| LBN Legal business name | Coburn, Jerry K |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 7th, 2006 |
| Last updated | Jul 8th, 2010 - about 15 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 | 1083681159 | NPPES |
| Oklahoma | MEDICAID | 100766490A |
Popular Providers
-
Parker, Bill Dan
1157 N York St , Muskogee OK 74403-2520 -
Charlton, Angela Sue
742 N. York , Muskogee OK 74403 -
Odom, Ray V
742 N York St , Muskogee OK 74403-3866 -
Nelson, Michael Hennen
105 N York St , Muskogee OK 74403-4657 -
Flusche, Gary Frances
1157 N York St , Muskogee OK 74403-2520 -
Creed, Richard Dan
3705 W Broadway St , Muskogee OK 74401-2142 -
Stewart, Candace Yolande
435 W Broadway , Muskogee OK 74401 -
Nelson, James M
3101 Chandler Rd Suite 105, Muskogee OK 74403-4954