Northeastern State University Oklahoma College Of Optometry | |
1001 N Grand Ave, Tahlequah, OK 74464-7017 | |
(918) 458-2109 | |
(918) 458-2310 |
Full Name | Northeastern State University Oklahoma College Of Optometry |
---|---|
Type | Facility |
Speciality | Optometrist |
Location | 1001 N Grand Ave, Tahlequah, Oklahoma |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1437106333 | NPI | - | NPPES |
100732440A | Medicaid | OK |
Provider Name | Alan G Mckee |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1326068750 PECOS PAC ID: 8921099292 Enrollment ID: I20040524001282 |
Provider Name | Earlena F Mckee |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1235159666 PECOS PAC ID: 6406742980 Enrollment ID: I20040525000139 |
Provider Name | Judith A Riley |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1609879238 PECOS PAC ID: 4082656640 Enrollment ID: I20050524001444 |
Provider Name | Alissa K Proctor |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1972523751 PECOS PAC ID: 4385679919 Enrollment ID: I20051022000242 |
Provider Name | Leland W Carr |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1891786778 PECOS PAC ID: 7315959756 Enrollment ID: I20060629000041 |
Provider Name | Jason Ellen |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1962405928 PECOS PAC ID: 7214036821 Enrollment ID: I20070622000222 |
Provider Name | Heidi A Thoden |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1295754299 PECOS PAC ID: 2860389285 Enrollment ID: I20070808000482 |
Provider Name | Alan D Grover |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1760672331 PECOS PAC ID: 7810077419 Enrollment ID: I20080109000140 |
Provider Name | Billy Wayne Hill |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1669454856 PECOS PAC ID: 9931270022 Enrollment ID: I20080617000567 |
Provider Name | Kathleen F Elliott |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1558378794 PECOS PAC ID: 6103998919 Enrollment ID: I20080710000296 |
Provider Name | Jenna M Lighthizer |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1154586501 PECOS PAC ID: 4981759479 Enrollment ID: I20090904000493 |
Provider Name | Nathan R Lighthizer |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1366671497 PECOS PAC ID: 6608913694 Enrollment ID: I20091023000310 |
Provider Name | Mary Sturm |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1437279924 PECOS PAC ID: 9133269574 Enrollment ID: I20091216000361 |
Provider Name | Jari Jill Frazier |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1326087636 PECOS PAC ID: 4587791041 Enrollment ID: I20100415000227 |
Provider Name | Ryan E Fenska |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1730342684 PECOS PAC ID: 8022184985 Enrollment ID: I20100714000433 |
Provider Name | Gary F Flusche |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1780601666 PECOS PAC ID: 3476682212 Enrollment ID: I20100714000524 |
Provider Name | Spencer D Johnson |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1487747408 PECOS PAC ID: 1254365034 Enrollment ID: I20101110000919 |
Provider Name | Sarah G Krein |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1841503919 PECOS PAC ID: 0345365094 Enrollment ID: I20101209001204 |
Provider Name | Tory Dotson |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1790099786 PECOS PAC ID: 8921293275 Enrollment ID: I20101214000394 |
Provider Name | Sarah Wade |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1144533241 PECOS PAC ID: 5890983928 Enrollment ID: I20101216000202 |
Provider Name | Jackie L Burress |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1851604961 PECOS PAC ID: 7315135449 Enrollment ID: I20101216000223 |
Provider Name | Saunya M Burkhart |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1912211350 PECOS PAC ID: 0941485528 Enrollment ID: I20110425000758 |
Provider Name | Stephanie M Cooper |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1255619771 PECOS PAC ID: 4688846637 Enrollment ID: I20111017000521 |
Provider Name | Henricus G Vanveen |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1871510461 PECOS PAC ID: 5890681605 Enrollment ID: I20120203000588 |
Provider Name | Latricia D Pack |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1043230477 PECOS PAC ID: 7517854987 Enrollment ID: I20120203000617 |
Provider Name | Wesley J Derosier |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1760401764 PECOS PAC ID: 9234026170 Enrollment ID: I20120203000641 |
Provider Name | Jeff M Miller |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1144240573 PECOS PAC ID: 5092602482 Enrollment ID: I20120203000660 |
Provider Name | Richard E Castillo |
---|---|
Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1679593008 PECOS PAC ID: 3870480288 Enrollment ID: I20120221001034 |
Provider Name | Charles Neal Whittle |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1427304799 PECOS PAC ID: 5799933636 Enrollment ID: I20120918000404 |
Provider Name | Amy E Slama |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1962758078 PECOS PAC ID: 4385892272 Enrollment ID: I20120918000944 |
Provider Name | Jonathan M Hatley |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1770839979 PECOS PAC ID: 0840448601 Enrollment ID: I20120924000470 |
Provider Name | Daniel D Owen |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1962758201 PECOS PAC ID: 5698921690 Enrollment ID: I20130102000371 |
Provider Name | Joseph Leon Shetler |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1952362139 PECOS PAC ID: 4486609831 Enrollment ID: I20130513000474 |
Provider Name | Emily L Bruce |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1629410105 PECOS PAC ID: 1759525314 Enrollment ID: I20130920000504 |
Provider Name | Kelsey D Grounds |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1629416789 PECOS PAC ID: 6406090018 Enrollment ID: I20130923000227 |
Provider Name | Bryan L Young |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1962422394 PECOS PAC ID: 0547157950 Enrollment ID: I20131015000940 |
Provider Name | April J Parker |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1609218056 PECOS PAC ID: 8022245760 Enrollment ID: I20140421001782 |
Provider Name | Andrew S Whitley |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1588096432 PECOS PAC ID: 9436377678 Enrollment ID: I20140829000144 |
Provider Name | Brittany L Ellis |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1437483906 PECOS PAC ID: 7214156819 Enrollment ID: I20140912002042 |
Provider Name | Michael William Gaydos |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1225301443 PECOS PAC ID: 7113144098 Enrollment ID: I20141018000159 |
Provider Name | Kyle A Ryff |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1790193597 PECOS PAC ID: 5991924979 Enrollment ID: I20141020002754 |
Provider Name | Molly G Tebow |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1811305659 PECOS PAC ID: 2961623590 Enrollment ID: I20141024001007 |
Provider Name | Amy Dang |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1740698539 PECOS PAC ID: 5890915045 Enrollment ID: I20141024001899 |
Provider Name | Blake Carlisle |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1073921524 PECOS PAC ID: 9638390826 Enrollment ID: I20141103000978 |
Provider Name | Kelly K Boucher |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1528476207 PECOS PAC ID: 1456571017 Enrollment ID: I20141104001906 |
Provider Name | Kristin L Law |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1811300841 PECOS PAC ID: 5092935916 Enrollment ID: I20141104002015 |
Provider Name | Marshall Walker |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1033554118 PECOS PAC ID: 6103149083 Enrollment ID: I20141229001826 |
Provider Name | Matthew B Geiger |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1790160612 PECOS PAC ID: 4183932692 Enrollment ID: I20151002001551 |
Provider Name | Matthew D Krein |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1316250459 PECOS PAC ID: 5799950697 Enrollment ID: I20160108000983 |
Provider Name | Wyatt Ray Williams |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1750766325 PECOS PAC ID: 3375845100 Enrollment ID: I20160111001303 |
Provider Name | Tara D Brown |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1093824195 PECOS PAC ID: 1254622426 Enrollment ID: I20160617000909 |
Provider Name | Tyler W Kitzman |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1164875787 PECOS PAC ID: 7416243563 Enrollment ID: I20160915002089 |
Provider Name | Benjamin Christopher Konig |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1497108070 PECOS PAC ID: 9830486885 Enrollment ID: I20160920000771 |
Provider Name | Clement I Nwadozi |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1548713456 PECOS PAC ID: 6406143825 Enrollment ID: I20161010002171 |
Provider Name | Bret R Seamons |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1548512882 PECOS PAC ID: 8729379078 Enrollment ID: I20161024000508 |
Provider Name | Dawn Pewitt |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1942248323 PECOS PAC ID: 1850670266 Enrollment ID: I20161107002550 |
Provider Name | Kelly E Glass |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1023425675 PECOS PAC ID: 7416273529 Enrollment ID: I20161215001722 |
Provider Name | Phillip C Ford |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1932585106 PECOS PAC ID: 3678857745 Enrollment ID: I20170309001105 |
Provider Name | Chad Tyler Hollifield |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1215450671 PECOS PAC ID: 6305118423 Enrollment ID: I20170823003408 |
Provider Name | Andrew S Young |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1447773452 PECOS PAC ID: 5092089573 Enrollment ID: I20170921002668 |
Provider Name | Nicholas Green |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1922532811 PECOS PAC ID: 3274807797 Enrollment ID: I20170922000622 |
Provider Name | Elizabeth Escobedo |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1235652553 PECOS PAC ID: 2860766391 Enrollment ID: I20170922000925 |
Provider Name | Pamela Martin |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1538682992 PECOS PAC ID: 0143594572 Enrollment ID: I20170922001380 |
Provider Name | Brent L Roberts |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1114440138 PECOS PAC ID: 1850665282 Enrollment ID: I20170922001486 |
Provider Name | Jessica L White |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1386167435 PECOS PAC ID: 5991079352 Enrollment ID: I20170922002745 |
Provider Name | Jonathan M Janzen |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1275056574 PECOS PAC ID: 8628342037 Enrollment ID: I20170925001110 |
Provider Name | Erelda Gene |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1801319041 PECOS PAC ID: 9931473154 Enrollment ID: I20170926003367 |
Provider Name | Anthony John E. Castanares |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1235629361 PECOS PAC ID: 3779834874 Enrollment ID: I20181001000372 |
Provider Name | Jenny Ga-yee Lau |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1093292849 PECOS PAC ID: 1850642844 Enrollment ID: I20181002001380 |
Provider Name | Sergiu Daniel Picioreanu |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1235616897 PECOS PAC ID: 3173875184 Enrollment ID: I20181002002274 |
Provider Name | James H Hsiau |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1235449869 PECOS PAC ID: 0840476784 Enrollment ID: I20181004000161 |
Provider Name | Caitlin B Chevalier |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1548747272 PECOS PAC ID: 1456602002 Enrollment ID: I20181016000323 |
Provider Name | Seth Allen Rich |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1467939330 PECOS PAC ID: 2769734136 Enrollment ID: I20181016001825 |
Provider Name | Glen R Owen |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1174613715 PECOS PAC ID: 2860423043 Enrollment ID: I20190131003047 |
Provider Name | Kelsey L Buford |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1821641267 PECOS PAC ID: 1658609664 Enrollment ID: I20190828001839 |
Provider Name | Laura Lai Ming L M Chan |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1063065522 PECOS PAC ID: 2365771334 Enrollment ID: I20190917002256 |
Provider Name | Dana D Rhea |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1629621263 PECOS PAC ID: 4880924711 Enrollment ID: I20190919001366 |
Provider Name | Nha Cao |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1932660974 PECOS PAC ID: 7113359399 Enrollment ID: I20191209000390 |
Provider Name | Jennifer A Button |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1104478296 PECOS PAC ID: 7012340847 Enrollment ID: I20191209000819 |
Provider Name | Carolyn E Majcher |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1033407127 PECOS PAC ID: 6406025733 Enrollment ID: I20200122000069 |
Provider Name | Louis Allen Blowers |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1487144424 PECOS PAC ID: 7214362920 Enrollment ID: I20200323002649 |
Provider Name | Janet Poole Naguib |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1992330534 PECOS PAC ID: 8123442779 Enrollment ID: I20200806002759 |
Provider Name | Sylvester Cobbina |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1225411358 PECOS PAC ID: 0446678072 Enrollment ID: I20200915000935 |
Provider Name | Kristen Lantz |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1073132395 PECOS PAC ID: 7911325444 Enrollment ID: I20200916000860 |
Provider Name | Jennifer L Dryden |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1588285613 PECOS PAC ID: 2668890096 Enrollment ID: I20200916001212 |
Provider Name | Colleen Annalina Tejchma |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1811518004 PECOS PAC ID: 4284052663 Enrollment ID: I20200916003029 |
Provider Name | Amy Burcham |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1023637360 PECOS PAC ID: 5496173676 Enrollment ID: I20200921001639 |
Provider Name | Carol Ann Chou |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1366061038 PECOS PAC ID: 2264850395 Enrollment ID: I20200922000720 |
Provider Name | Christian Bussey |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1578172284 PECOS PAC ID: 8224457064 Enrollment ID: I20201008000927 |
Provider Name | Paige E Taylor |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1356910178 PECOS PAC ID: 8729483565 Enrollment ID: I20210817003647 |
Provider Name | Elaine Victoria Petry |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1083296669 PECOS PAC ID: 7416352125 Enrollment ID: I20210818002814 |
Provider Name | Hannah R Sanders |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1396310637 PECOS PAC ID: 3274938998 Enrollment ID: I20210818003171 |
Provider Name | Komal Patel |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1306417308 PECOS PAC ID: 6204231897 Enrollment ID: I20210819002372 |
Provider Name | Sweta K Das |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1245758150 PECOS PAC ID: 1658777305 Enrollment ID: I20210907000792 |
Provider Name | Jacob J Dufour |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1730556580 PECOS PAC ID: 8224326640 Enrollment ID: I20210908003990 |
Provider Name | Hannah H Munyan |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1063092468 PECOS PAC ID: 1052701869 Enrollment ID: I20220613000468 |
Provider Name | Cedrick K Mah |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1093447898 PECOS PAC ID: 5597148460 Enrollment ID: I20220810003111 |
Provider Name | Alexander Finley Kinsinger |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1679214308 PECOS PAC ID: 3476936352 Enrollment ID: I20220810003692 |
Provider Name | Courtney D Simon |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1114663085 PECOS PAC ID: 5193108975 Enrollment ID: I20220811000254 |
Provider Name | Baylee R Moles |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1104561851 PECOS PAC ID: 8921481730 Enrollment ID: I20220811001122 |
Provider Name | Cole Sutherland |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1639801434 PECOS PAC ID: 7911380753 Enrollment ID: I20220811002525 |
Provider Name | Alia K Cappellani |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1679205801 PECOS PAC ID: 6507249208 Enrollment ID: I20220812001748 |
Provider Name | Matthew Bills |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1760132765 PECOS PAC ID: 5597148924 Enrollment ID: I20220818000866 |
Provider Name | Jordan H Fleming |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1003489527 PECOS PAC ID: 0042608028 Enrollment ID: I20230228002433 |
Provider Name | Megan Rae Tucker |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1134857279 PECOS PAC ID: 8921472242 Enrollment ID: I20230801001925 |
Provider Name | Aubry Tackett |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1871289173 PECOS PAC ID: 5597129098 Enrollment ID: I20230918001326 |
Provider Name | Ethan Wohlgemuth |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1104506419 PECOS PAC ID: 8921460627 Enrollment ID: I20230918003837 |
Provider Name | Jessica Tarka |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1811628613 PECOS PAC ID: 5799147476 Enrollment ID: I20230919004052 |
Provider Name | Adam M Provost |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1497486260 PECOS PAC ID: 5395190730 Enrollment ID: I20231004004068 |
Provider Name | Meghan Alicia Sue |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1831962554 PECOS PAC ID: 6709236391 Enrollment ID: I20231221004181 |
Mailing Address | Practice Location Address |
---|---|
Northeastern State University Oklahoma College Of Optometry 1001 N Grand Ave, Tahlequah, OK 74464-7017 Ph: (918) 458-2109 | Northeastern State University Oklahoma College Of Optometry 1001 N Grand Ave, Tahlequah, OK 74464-7017 Ph: (918) 458-2109 |
Dr. Michele Bither-marshall, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1001 N Grand Ave, Tahlequah, OK 74464 Phone: 918-458-2109 Fax: 918-458-2310 | |
Dr. Rodney Bendure, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1001 N Grand Ave, Tahlequah, OK 74464 Phone: 918-458-2109 Fax: 918-458-2310 | |
Tahlequah Family Vision Clinic Optometrist Medicare: Medicare Enrolled Practice Location: 681 W Choctaw St, Tahlequah, OK 74464 Phone: 918-456-2250 Fax: 918-456-2251 | |
Dr. Megan Jean Chee, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 1001 N Grand Ave, Nsu Oklahoma College Of Optometry, Tahlequah, OK 74464 Phone: 918-444-4031 | |
Dr. Latricia Pack, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 1001 N Grand Ave, Tahlequah, OK 74464 Phone: 918-458-2109 Fax: 918-458-2310 | |
Dr. Laura Lai Ming Chan, OD Optometrist Medicare: Medicare Enrolled Practice Location: 1001 N Grand Ave, Tahlequah, OK 74464 Phone: 918-444-4000 | |
Hannah Munyan Sikes, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 1001 N Grand Ave, Tahlequah, OK 74464 Phone: 918-444-4007 |