| |
218 W Main St, Wilburton, OK 74578-4046 | |
(918) 465-3780 | |
(918) 465-3313 |
Full Name | |
---|---|
Type | Facility |
Speciality | Optometrist |
Location | 218 W Main St, Wilburton, Oklahoma |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1124174966 | NPI | - | NPPES |
200090590A | Medicaid | OK | |
100851340A | Medicaid | OK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
218 W Main St, Wilburton, OK 74578-4046 Ph: (918) 465-3780 | 218 W Main St, Wilburton, OK 74578-4046 Ph: (918) 465-3780 |
Dr. Matt L Grantham, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 218 W Main St, Wilburton, OK 74578 Phone: 918-465-3780 Fax: 918-465-3313 |