| Southwest Eye Clinic, Pllc | |
|
1240 Sw 44th St Oklahoma City OK 73109-3604 | |
| (405) 631-1527 | |
| (405) 631-9930 |
| Full Name | Southwest Eye Clinic, Pllc |
|---|---|
| Speciality | General Practice |
| Location | 1240 Sw 44th St, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | David B Mallory (CEO/MANAGER) |
| Authorized Official Contact | 4056311527 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southwest Eye Clinic, Pllc 1240 Sw 44th St Oklahoma City OK 73109-3604 Ph: (405) 631-1527 | Southwest Eye Clinic, Pllc 1240 Sw 44th St Oklahoma City OK 73109-3604 Ph: (405) 631-1527 |
| NPI Number | 1386725224 |
|---|---|
| Provider Enumeration Date | 10/18/2006 |
| Last Update Date | 08/06/2024 |
| Medicare PECOS PAC ID | 2961438692 |
|---|---|
| Medicare Enrollment ID | O20050713000735 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386725224 | NPI | - | NPPES |
| 100059640A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 208D00000X (Oklahoma) | Primary |
| Provider Name | Kurtis D Weir |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1841200037 PECOS PAC ID: 9436052990 Enrollment ID: I20050714000147 |
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