| |
301 S Main St, Lindsay, OK 73052-5635 | |
(405) 756-4414 | |
(405) 756-4415 |
Full Name | |
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Type | Facility |
Speciality | Optometrist |
Location | 301 S Main St, Lindsay, Oklahoma |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1225253149 | NPI | - | NPPES |
100761590A | Medicaid | OK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | OK 1041 (Oklahoma) | Primary |
Provider Name | Mike Boeckman |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1962419796 PECOS PAC ID: 7315054293 Enrollment ID: I20110606000649 |
Mailing Address | Practice Location Address |
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301 S Main St, Lindsay, OK 73052-5635 Ph: (405) 756-4414 | 301 S Main St, Lindsay, OK 73052-5635 Ph: (405) 756-4414 |
Dr. Michael Boeckman, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 301 S Main St, Lindsay, OK 73052 Phone: 405-756-4414 Fax: 405-756-4415 |