| |
3131 Military Blvd, Muskogee, OK 74401-2290 | |
(918) 687-6600 | |
(918) 307-1983 |
Full Name | |
---|---|
Type | Facility |
Speciality | Ophthalmology |
Location | 3131 Military Blvd, Muskogee, Oklahoma |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1447382833 | NPI | - | NPPES |
CO5028 | Other | OK | RAILROAD MEDICARE |
490004258 | Other | OK | RAILROAD MEDICARE |
100738620D | Medicaid | OK | |
490000830 | Other | OK | RAILROAD MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 731288036 (Oklahoma) | Secondary |
207W00000X | Ophthalmology | 731288036 (Oklahoma) | Primary |
Mailing Address | Practice Location Address |
---|---|
6140 S Memorial Dr, Tulsa, OK 74133-1933 Ph: (918) 252-2020 | 3131 Military Blvd, Muskogee, OK 74401-2290 Ph: (918) 687-6600 |