Organization Name: | MAX CARLISLE OD PC |
NPI Number: | 1225183957 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MAX CARLISLE (OPTOMETRIST) |
Mailing Address: | 111 E Broadway Fairview |
State: | OK US |
Postal Code: | 737372124 |
Phone Number: | 5802274878 |
Fax Number: | 5802274666 |
NPI Enumeration Date: | 01/24/2007 |
NPI Last Update Date: | 03/31/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332H00000X |
License Number: | 973 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | OK |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Eyewear Supplier (Equipment, not the service) |
Taxonomy Specialization: | |
Taxonomy Definition: | An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |