WAGONER EYE CLINIC INC (NPI# 1497826358) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497826358 |
| Entity Type | Organization |
| Organization Name | WAGONER EYE CLINIC INC |
| Practice Address |
1108 W Cherokee St Wagoner OK 74467-4622 |
| Practice Telephone | 9184852123 |
| Practice Fax Number | 9184854777 |
| Mailing Telephone | 9184852123 |
| Mailing Fax Number | 9184854777 |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2012-09-14 |
| Authorized Official Name | JEFFREY ALAN MITCHELL (PRESIDENT) |
| Authorized Official Telephone | 9184852123 |
| Authorized Official Credential | O.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 2018 | OK | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 100759760A | 05 |
| Street Address |
1108 W CHEROKEE ST |
| City | WAGONER |
| State | OK |
| Zip Code | 74467-4622 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750495206 | Jeffrey A Mitchell | Optometrist | 1108 W Cherokee St, Wagoner, OK 74467-4622 | 2006-08-19 |
| 1881232593 | Mbr Eye LLC | Optometrist | 1108 W Cherokee St, Wagoner, OK 74467-4622 | 2019-12-12 |
| 1083167027 | Kari Lynn Wilkerson | Optometrist | 1108 W Cherokee St, Wagoner, OK 74467-4622 | 2016-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982251591 | Alesha Lenard | Behavior Technician | 901 S. Harrill Ave, Wagoner, OK 74467 | 2019-08-20 |
| 1679030597 | Lorri Dawn Pitchford | Case Manager/Care Coordinator | Creoks Behavioral Health Services, 109 S Harrill Ave., Wagoner, OK 74467 | 2019-02-27 |
| 1144769399 | Elaina Murray | Technician | 308 Ne 2nd St., Wagoner, OK 74467 | 2017-02-21 |
| 1336699784 | Tommye Evidson | Counselor | 109 Harrill Ave, Wagoner, OK 74467 | 2016-10-10 |
| 1518327857 | Yco Tulsa, Inc | Clinic/Center | 1101a South Mcquarrie, Wagoner, OK 74467 | 2016-02-29 |
| 1396117545 | Sandra Cooper | Behavioral Analyst | 2109 Us-69, Wagoner, OK 74467 | 2015-10-28 |
| 1588051486 | Penny Nye | Counselor | 2109 S.hwy 69, Wagoner, OK 74467 | 2015-04-20 |
| 1376943571 | Justin F Kurtz | Respiratory Therapist, Certified | 1200 W. Cherokee, Suite H Cardiac/pulmonary Rehab, Wagoner, OK 74467 | 2014-08-26 |
| 1780009969 | David H Good | Family Medicine | 1202 W. Cherokee St, Ste E, Wagoner, OK 74467 | 2014-02-25 |
| 1942598875 | Robin Rodriguez-higginbottom | Speech-Language Pathologist | 215 E Cherokee St, Wagoner, OK 74467 | 2011-07-12 |
| Find all providers in zip 74467 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609054303 | William R Homan | Optometrist | 709 E Cherokee St, Wagoner, OK 74467-4713 | 2008-02-05 |
| 1881602407 | Shelly Deann Rice | Optometrist | 512 E Cherokee St, Wagoner, OK 74467-4710 | 2006-08-03 |
| 1134149560 | John Lindsay | Optometrist | 200 E Cherokee St, Wagoner, OK 74467-4704 | 2006-07-20 |
| 1881232593 | Mbr Eye LLC | Optometrist | 1108 W Cherokee St, Wagoner, OK 74467-4622 | 2019-12-12 |
| 1083167027 | Kari Lynn Wilkerson | Optometrist | 1108 W Cherokee St, Wagoner, OK 74467-4622 | 2016-07-26 |
| 1497746556 | William R Homan | Optometrist | 709 E Cherokee St, Wagoner, OK 74467-4713 | 2005-10-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831799113 | Mel Vision LLC | Optometrist | 415 S Macarthur Blvd, Oklahoma City, OK 73128-1010 | 2020-10-27 |
| 1609475540 | Mel Vision LLC | Optometrist | 6310 N May Ave, Oklahoma City, OK 73112-4298 | 2020-10-21 |
| 1346849528 | Mel Vision LLC | Optometrist | 1413 W Interstate 240 Service Rd, Suite E, Oklahoma City, OK 73159 | 2020-10-20 |
| 1770190779 | Nate Richard Castillo | Optometrist | 2625 Cambridge Cir, Tahlequah, OK 74464-4690 | 2020-09-24 |
| 1427663731 | Kathryn Elizabeth Kubiak | Optometrist | 1811 W Grant Ave, Pauls Valley, OK 73075-9202 | 2020-09-14 |
| 1861006918 | Haley Ruth Rasp Sparks | Optometrist | 8812 N Council Rd, Oklahoma City, OK 73132-3246 | 2020-09-06 |
| 1487264495 | Blake Zoellner | Optometrist | 6999 S Memorial Drive, Tulsa, OK 74133-2052 | 2020-08-04 |
| 1588273080 | Nattali Nicole Masson | Optometrist | 1400 E Wade Watts Ave, Mcalester, OK 74501-5652 | 2020-07-30 |
| 1225647415 | Legacy Eye Care Pllc | Optometrist | 1207 Cornwell Dr, Yukon, OK 73099-4633 | 2020-07-24 |
| 1285252213 | Mid-del Vision Source Pllc | Optometrist | 1 Ne 2nd St Ste 104, Oklahoma City, OK 73104-2224 | 2020-07-07 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.