Wagoner Eye Clinic Inc

LBN: Wagoner Eye Clinic Inc
Wagoner Eye Clinic Inc is an health care organization with primary practice located at 1108 W Cherokee St , Wagoner OK 74467-4622. The organization recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as the primary health care specialty. Wagoner Eye Clinic Inc can be contacted via phone (918) 485-2123, or through Mitchell, Jeffrey Alan via phone (918) 485-2123.

Contact Information

Primary practice address
1108 W Cherokee St Wagoner OK 74467-4622
Phone: (918) 485-2123
Fax: (918) 485-4777
Website:
Map and Directions
Authorized official contact:
Name: Mitchell, Jeffrey Alan Doctor of Optometry (OD)
Phone: (918) 485-2123

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 2018 Oklahoma

Profile Details

NPI number 1497826358
LBN Legal business name Wagoner Eye Clinic Inc
DBA Doing business as
Authorized official Mitchell, Jeffrey Alan Doctor of Optometry (OD)
Entity Organization
Organization subpart 1 No
Enumeration date Nov 13th, 2006
Last updated Sep 14th, 2012 - about 12 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 1497826358 NPPES
Oklahoma MEDICAID 100759760A

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