Shoemaker, Tracy L
Shoemaker, Tracy L is an individual health care provider with primary practice located at 4008 S Elm Pl Ste A, Broken Arrow OK 74011. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Shoemaker, Tracy L can be contacted via phone (918) 455-2020.Contact Information
Primary practice address
4008 S Elm Pl Ste A
Broken Arrow OK 74011
Phone: (918) 455-2020
Fax: (918) 455-4030
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | OD00004159 | Washington |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2837 | Oklahoma |
Profile Details
| NPI number | 1215135611 |
|---|---|
| LBN Legal business name | Shoemaker, Tracy L |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 6th, 2007 |
| Last updated | Mar 28th, 2024 - about 8 months 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 | 1215135611 | NPPES |
| Washington | MEDICAID | 2034155 | |
| Washington | MEDICAID | 200617840A |
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