Healthcare Provider Details

I. General information

NPI: 1902083280
Provider Name (Legal Business Name): M. PATRICK DAY, OD, A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2008
Last Update Date: 09/27/2023
Certification Date: 09/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

565 S 30TH ST
CLINTON OK
73601-3656
US

IV. Provider business mailing address

PO BOX 606
CLINTON OK
73601-0606
US

V. Phone/Fax

Practice location:
  • Phone: 580-323-5421
  • Fax: 866-585-2957
Mailing address:
  • Phone: 580-323-5421
  • Fax: 866-585-2957

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number918
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: MARSHALL PATRICK DAY
Title or Position: CO-OWNER/OPTOMETRIST
Credential: OD
Phone: 580-323-5421