MEDICARE: ANTHONY ECONOMOU DO PC

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	207W00000X	Ophthalmology Physician
2	207WX0009X	Glaucoma Specialist (Ophthalmology) Physician

General Provider Information

NPI Number	:	1871613547
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANTHONY ECONOMOU DO PC

Provider Business Mailing Address
First Line	:	2865 E SKELLY DR STE 250
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74105-6233
Country	:	US
Telephone Number	:	918-317-0022
Fax Number	:	855-327-9828

Provider Business Practice Location Address
First Line	:	2865 E SKELLY DR STE 250
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74105-6233
Country	:	US
Telephone Number	:	918-317-0022
Fax Number	:	855-327-9828

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ANTHONY ECONOMOU
Credential	:	D.O.
Telephone Number	:	918-317-0022

Provider Enumeration Date	:	03/29/2007
Last Update Date	:	02/10/2021

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Directions to “ANTHONY ECONOMOU DO PC ” Practice Location

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