Kenmore, Todd Alan
Kenmore, Todd Alan is an sole proprietor health care provider with primary practice located at 513 N Telephone Rd , Moore OK 73160-4938. He recently has 9 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, Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Eyewear Supplier (Equipment, not the service). Eye and Vision Services Providers / Optometrist is his primary health care specialty. Kenmore, Todd Alan can be contacted via phone (405) 799-3030.Contact Information
Primary practice address
513 N Telephone Rd
Moore OK 73160-4938
Phone: (405) 799-3030
Fax: (405) 799-3737
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Eye and Vision Services Providers / Optometrist | 152W00000X | 2366 | Oklahoma |
Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | 2366 | Oklahoma |
Eye and Vision Services Providers / Low Vision Rehabilitation | 152WL0500X | 2366 | Oklahoma |
Eye and Vision Services Providers / Pediatrics | 152WP0200X | 2366 | Oklahoma |
Eye and Vision Services Providers / Sports Vision | 152WS0006X | 2366 | Oklahoma |
Eye and Vision Services Providers / Vision Therapy | 152WV0400X | 2366 | Oklahoma |
Eye and Vision Services Providers / Occupational Vision | 152WX0102X | 2366 | Oklahoma |
Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | 2366 | Oklahoma |
Suppliers / Eyewear Supplier (Equipment, not the service) | 332H00000X | 2366 | Oklahoma |
Profile Details
NPI number | 1508870437 |
---|---|
LBN Legal business name | Kenmore, Todd Alan |
Credentials | Doctor of Optometry (OD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Jul 28th, 2006 |
Last updated | Feb 7th, 2008 - about 16 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 | 1508870437 | NPPES |
Oklahoma | MEDICAID | 200019180B | |
Oklahoma | Other | 010814058 |
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