Healthcare Provider Details

I. General information

NPI: 1740102094
Provider Name (Legal Business Name): CLAY BUCHANAN OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1811 W GRANT AVE
PAULS VALLEY OK
73075-9202
US

IV. Provider business mailing address

1811 W GRANT AVE
PAULS VALLEY OK
73075-9202
US

V. Phone/Fax

Practice location:
  • Phone: 405-238-6459
  • Fax:
Mailing address:
  • Phone: 405-238-6459
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number3380
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: