Healthcare Provider Details

I. General information

NPI: 1578651188
Provider Name (Legal Business Name): DAVID MACARTY, OD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 07/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 N GLENN L ENGLISH ST
CORDELL OK
73632-2015
US

IV. Provider business mailing address

1200 N GLENN L ENGLISH ST
CORDELL OK
73632-2015
US

V. Phone/Fax

Practice location:
  • Phone: 580-832-3385
  • Fax: 580-832-3990
Mailing address:
  • Phone: 580-832-3385
  • Fax: 580-832-3990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2045
License Number StateOK

VIII. Authorized Official

Name: DR. JOHN DAVID MACARTY
Title or Position: OPTOMETRIST/OWNER
Credential: O.D.
Phone: 580-832-3385