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General NPI Number Information
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NPI Number | 1225369267
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Entity Type | Organization
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Legal Business Name | DRS. FORD AND EDWARDS, PLLC
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Dates
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Enumeration Date | 01/14/2010
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Last Update Date | 02/21/2012
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Provider Practice Location Address
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Address Line | 101 N RANDALL AVE
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City | ELK CITY
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State | OK
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Zip | 73644-5231
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Country | US
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Telephone | 580-225-1980
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Fax | 580-225-8648
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Provider Business Mailing Address
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Address Line | PO BOX 624
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City | ELK CITY
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State | OK
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Zip | 73648-0624
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Country | US
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Telephone | 580-225-1980
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Fax | 580-225-8648
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Authorized Official
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Title or Position | CO-OWNER
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Name | DR. GARY L FORD
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Credential | OD
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Telephone | 580-225-1980
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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 |
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License Number State |
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