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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| 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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