Doctor Name: | MR. MAX L CARLISLE |
NPI Number: | 1205839685 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | O.D. |
License Number: | 973 |
Business Practice Address: | 111 E Broadway Fairview, OK - 737372124 |
Business Phone Number: | 5802274878 |
Business Fax Number: | 5802274666 |
Mailing Address: | 111 E Broadway, FAIRVIEW |
State: | OK |
Postal Code: | 737372124 |
Phone Number: | 5802274878 |
Fax Number: | 5802274666 |
NPI Enumeration Date: | 05/31/2005 |
NPI Last Update Date: | 12/23/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 152WC0802X |
License Number: | 973 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | OK |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Optometrist |
Taxonomy Specialization: | Corneal and Contact Management |
Taxonomy Definition: | The professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea |