| |
400 S Main St, Shattuck, OK 73858 | |
(580) 938-5210 | |
(580) 938-2166 |
Full Name | |
---|---|
Type | Facility |
Speciality | Optometrist |
Location | 400 S Main St, Shattuck, Oklahoma |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1245309095 | NPI | - | NPPES |
410049616 | Other | OK | RAILROAD MEDICARE |
200078760A | Medicaid | OK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 2374 (Oklahoma) | Primary |
332H00000X | Eyewear Supplier | (* (Not Available)) | Secondary |
Mailing Address | Practice Location Address |
---|---|
Po Box 770, Shattuck, OK 73858-0770 Ph: (580) 938-5210 | 400 S Main St, Shattuck, OK 73858 Ph: (580) 938-5210 |