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General NPI Number Information
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NPI Number | 1164416574
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Entity Type | Individual
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Provider Name | OLIN W FENTON OD
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Gender | Male
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Dates
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Enumeration Date | 08/31/2005
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Last Update Date | 11/12/2025
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Provider Practice Location Address
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Address Line | 200 DALLAS ST
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City | TALIHINA
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State | OK
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Zip | 74571-2402
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Country | US
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Telephone | 918-567-3424
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Fax | 918-567-3420
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Provider Business Mailing Address
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Address Line | 200 DALLAS ST
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City | TALIHINA
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State | OK
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Zip | 74571-2402
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Country | US
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Telephone | 918-567-3424
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Fax | 918-567-3420
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 6474TG
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2417
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License Number State | OK
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