Healthcare Provider Details

I. General information

NPI: 1205937539
Provider Name (Legal Business Name): ACTION OPTICAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 N PENNSYLVANIA AVE
OKLAHOMA CITY OK
73107-6412
US

IV. Provider business mailing address

1010 N PENNSYLVANIA AVE
OKLAHOMA CITY OK
73107-6412
US

V. Phone/Fax

Practice location:
  • Phone: 405-236-3838
  • Fax:
Mailing address:
  • Phone: 405-236-3838
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number
License Number State

VIII. Authorized Official

Name: MR. TOM W. WILKINSON
Title or Position: PRESIDENT
Credential:
Phone: 405-236-3838