| |
206 E Main St, Tuttle, OK 73089-9138 | |
(405) 381-2244 | |
(405) 381-2246 |
Full Name | |
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Type | Facility |
Speciality | Optometrist |
Location | 206 E Main St, Tuttle, Oklahoma |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1952431439 | NPI | - | NPPES |
200109170A | Medicaid | OK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 2491 (Oklahoma) | Primary |
Provider Name | Crystal Y Mosteller |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1386744977 PECOS PAC ID: 4486755527 Enrollment ID: I20070719000559 |
Mailing Address | Practice Location Address |
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Po Box 1377, Tuttle, OK 73089-1377 Ph: (405) 381-2244 | 206 E Main St, Tuttle, OK 73089-9138 Ph: (405) 381-2244 |
Dr. Crystal Yvonne Mosteller, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 206 E Main St, Tuttle, OK 73089 Phone: 405-381-2244 Fax: 405-381-2246 |