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NPI Code Detail

MEDICARE: STACY G PRESLEY OD PLLC

MEDICARE: STACY G PRESLEY OD PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical Supplies2431OK
2152W00000XOptometrist2431OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1063542199
Entity Type Code : Organization
Provider Name (Legal Business Name) : STACY G PRESLEY OD PLLC
Provider Business Mailing Address
First Line : 1433 ARLINGTON ST
Second Line :
City : ADA
State : OK
Zip : 74820-2636
Country : US
Telephone Number : 580-332-5606
Fax Number : 580-332-3946
Provider Business Practice Location Address
First Line : 1433 ARLINGTON ST
Second Line :
City : ADA
State : OK
Zip : 74820-2636
Country : US
Telephone Number : 580-332-5606
Fax Number : 580-332-3946
Authorized Official
Title or Position : OWNER
Name : MRS. STACY G PRESLEY
Credential : OD
Telephone Number : 580-332-5606
Provider Enumeration Date : 03/07/2007
Last Update Date : 02/26/2013

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