Vision Source-okc South Pllc | |
10101 S Penn Ave, Suite A, Oklahoma City, OK 73159-6929 | |
(405) 691-3319 | |
(405) 691-1377 |
Full Name | Vision Source-okc South Pllc |
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Type | Facility |
Speciality | Optometrist |
Location | 10101 S Penn Ave, Oklahoma City, Oklahoma |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1629156617 | NPI | - | NPPES |
100760060A | Medicaid | OK | |
1629156617 | Other | OK | BCBS OK FEDERAL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | OK950 (Oklahoma) | Primary |
Provider Name | Brian D Morgan |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1083617054 PECOS PAC ID: 0042393340 Enrollment ID: I20100817000703 |
Provider Name | J. Travis Yadon |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1700820925 PECOS PAC ID: 1355465006 Enrollment ID: I20100901000489 |
Provider Name | Colby Ricks |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1114302064 PECOS PAC ID: 3072820711 Enrollment ID: I20150914001739 |
Mailing Address | Practice Location Address |
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Vision Source-okc South Pllc 10101 S Penn Ave, Suite A, Oklahoma City, OK 73159-6929 Ph: (405) 691-3319 | Vision Source-okc South Pllc 10101 S Penn Ave, Suite A, Oklahoma City, OK 73159-6929 Ph: (405) 691-3319 |
Dr. Gary Robert Fox, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 10320 S Pennsylvania Ave, Suite #103, Oklahoma City, OK 73159 Phone: 405-691-3937 Fax: 405-691-0312 | |
Jenna Vergeldt, OD Optometrist Medicare: Medicare Enrolled Practice Location: 921 Ne 13th St, Oklahoma City, OK 73104 Phone: 405-456-4017 |