Healthcare Provider Details

I. General information

NPI: 1417955352
Provider Name (Legal Business Name): SARAH LITTEKEN ROSS O.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2005
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1117 WALNUT DR
ARDMORE OK
73401-2354
US

IV. Provider business mailing address

1117 WALNUT DR
ARDMORE OK
73401-2354
US

V. Phone/Fax

Practice location:
  • Phone: 580-223-4500
  • Fax: 580-223-4540
Mailing address:
  • Phone: 580-223-4500
  • Fax: 580-223-4540

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2402
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: