Grand Lake Eye Care, Pc in Grove - Specialist
Grand Lake Eye Care, Pc - NPI 1073649844
Grand Lake Eye Care, Pc is a Specialist in Grove, Oklahoma. Grand Lake Eye Care, Pc practices all healthcare services and medical treatments related to Specialist. The NPI Number for Grand Lake Eye Care, Pc is 1073649844. The last update date is 2010-11-18.
Grand Lake Eye Care, Pc's current location address is Po Box 450400, Grove, Oklahoma. You can contact this provider via phone number 9187872020 and fax number 9187876002. The mailing address for Grand Lake Eye Care, Pc is Po Box 450400, Grove, Oklahoma. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Grand Lake Eye Care, Pc |
|---|---|
| Address | Po Box 450400, Grove, Oklahoma |
| Phone Number | 9187872020 |
| Fax Number | 9187876002 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Toller K Kevin |
| Credentials | MD |
| Telephone Number | 9187872020 |
NPI Number Detail
| NPI Number | 1073649844 |
|---|---|
| Provider Enumeration Date | 2007-02-26 |
| Last Updated Date | 2010-11-18 |
Provider Mailing Address Detail
| Address | Po Box 450400 |
|---|---|
| City | Grove |
| State | Oklahoma (OK) |
| Post Code | 74345 |
| Phone Number | 9187872020 |
| Fax Number | 9187876002 |
Provider's Primary Taxonomy Detail
| Speciality | Specialist |
|---|---|
| Taxonomy | 174400000X |
| Licence No | 21196 |
|
Definition: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 100138230A | OK | -- | |
| 180037253 | OK | RAILROAD MEDICARE | |
| 200216660A | OK | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Grand Lake Eye Care, Pc by the Centers for Medicare & Medicaid Services?
The Grand Lake Eye Care, Pc has been assigned the NPI (National Provider Identifier) 1073649844. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Where is the Grand Lake Eye Care, Pc located?
The Grand Lake Eye Care, Pc is located at Po Box 450400, Grove, OK 74345.
What is Grand Lake Eye Care, Pc's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Grand Lake Eye Care, Pc's specialized field of practice is Specialist, and the corresponding taxonomy code that categorizes this area of specialization is 174400000X.
When did Grand Lake Eye Care, Pc receive its 1073649844 assignment?
The Grand Lake Eye Care, Pc was assigned its 1073649844 on 2007-02-26, which is the date when this unique identifier was issued to the organization.
As of what date were the details pertaining to Grand Lake Eye Care, Pc last refreshed?
The information related to the Grand Lake Eye Care, Pc, including its address, specialty, and other relevant details, was last updated on 2010-11-18.