MEDICARE: BETHANY HESS O.D.

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
1	152W00000X	Optometrist	2854	OK

General Provider Information

NPI Number	:	1134504939
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETHANY HESS O.D.

Provider Business Mailing Address
First Line	:	705 S OAKWOOD RD STE C1
Second Line	:
City	:	ENID
State	:	OK
Zip	:	73703-6277
Country	:	US
Telephone Number	:	580-237-9379
Fax Number	:

Provider Business Practice Location Address
First Line	:	402 S OAKWOOD RD STE A
Second Line	:
City	:	ENID
State	:	OK
Zip	:	73703-4945
Country	:	US
Telephone Number	:	580-237-9379
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/22/2015
Last Update Date	:	10/16/2024

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