Peck, Michael Lloyd

Peck, Michael Lloyd is an sole proprietor health care provider with primary practice located at 517 W Maine Ave , Enid OK 73701-5542. He recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Optician. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Peck, Michael Lloyd can be contacted via phone (580) 242-2300.

Contact Information

Primary practice address
517 W Maine Ave Enid OK 73701-5542
Phone: (580) 242-2300
Fax: (580) 233-7370
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 1058 Oklahoma
Eye and Vision Services Providers / Optician 156FX1800X 1058 Oklahoma

Profile Details

NPI number 1023026176
LBN Legal business name Peck, Michael Lloyd
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 4th, 2006
Last updated Dec 28th, 2009 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023026176 NPPES
Oklahoma Other 730794467004 BCBSOK
Oklahoma MEDICAID 100765010B BCBSOK
Oklahoma Other 410001137 BCBSOK
Oklahoma Other 0582320001 BCBSOK

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