Healthcare Provider Details

I. General information

NPI: 1588701882
Provider Name (Legal Business Name): DANIEL G BINTZ, OD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 N MAIN ST
ELK CITY OK
73644-2828
US

IV. Provider business mailing address

PO BOX 9
ELK CITY OK
73648-0009
US

V. Phone/Fax

Practice location:
  • Phone: 580-243-1121
  • Fax: 580-243-1145
Mailing address:
  • Phone: 580-243-1121
  • Fax: 580-243-1145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DANIEL G BINTZ
Title or Position: PRESIDENT
Credential: O.D.
Phone: 580-243-1121