Organization Name: | MUSKOGEE REGIONAL EYE CLINIC INC |
NPI Number: | 1316069008 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHAEL L SOPER (OWNER) |
Mailing Address: | 329 S 38th St Muskogee |
State: | OK US |
Postal Code: | 744014945 |
Phone Number: | 9186879998 |
Fax Number: | 9186874135 |
NPI Enumeration Date: | 04/04/2007 |
NPI Last Update Date: | 04/20/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 11682 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy 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. |