Northeastern State University Oklahoma College Of Optometry

LBN: Northeastern State University College Of Optometry
Northeastern State University Oklahoma College Of Optometry is an health care organization with primary practice located at 1001 N Grand Ave , Tahlequah OK 74464-7017. The organization 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, Allopathic & Osteopathic Physicians / Ophthalmology, Suppliers / Eyewear Supplier (Equipment, not the service). Eye and Vision Services Providers / Optometrist is the primary health care specialty. Northeastern State University College Of Optometry can be contacted via phone (918) 458-2109, or through Penisten, Douglas via phone (918) 456-5511.

Contact Information

Primary practice address
1001 N Grand Ave Tahlequah OK 74464-7017
Fax: (918) 458-2310
Website:
Authorized official contact:
Name: Penisten, Douglas Doctor of Optometry (OD)

Profile Details

NPI number 1437106333
LBN Legal business name Northeastern State University College Of Optometry
DBA Doing business as Northeastern State University Oklahoma College Of Optometry
Authorized official Penisten, Douglas Doctor of Optometry (OD)
Entity Organization
Organization subpart 1 No
Enumeration date May 27th, 2006
Last updated Aug 30th, 2010 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437106333 NPPES
Oklahoma MEDICAID 100732440A

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