Elliott, Jeffery Dale
Elliott, Jeffery Dale is an sole proprietor health care provider with primary practice located at 1139 N Hills Ctr , Ada OK 74820-1882. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Elliott, Jeffery Dale can be contacted via phone (580) 332-6000.Contact Information
Primary practice address
1139 N Hills Ctr
Ada OK 74820-1882
Phone: (580) 332-6000
Fax: (580) 332-6006
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2241 | Oklahoma |
Profile Details
| NPI number | 1780766592 |
|---|---|
| LBN Legal business name | Elliott, Jeffery Dale |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 20th, 2006 |
| Last updated | Jan 17th, 2022 - about 3 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 | 1780766592 | NPPES |
| Oklahoma | MEDICAID | 100762790A |
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