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NPI 1427173970

NPI 1427173970 : WARNER FAMILY EYE CARE INC : MUSKOGEE, OK

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General NPI Number Information
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    NPI Number           |    1427173970
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    Entity Type          |    Organization 
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    Legal Business Name  |    WARNER FAMILY EYE CARE INC 
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Dates
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    Enumeration Date     |    03/20/2007
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    Last Update Date     |    03/13/2025
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Provider Practice Location Address
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    Address Line         |    3505 CHANDLER RD 
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    City                 |    MUSKOGEE
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    State                |    OK
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    Zip                  |    74403-4911
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    Country              |    US
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    Telephone            |    918-880-3937
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    Fax                  |    918-539-0030
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Provider Business Mailing Address
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    Address Line         |    3505 CHANDLER RD 
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    City                 |    MUSKOGEE
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    State                |    OK
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    Zip                  |    74403-4911
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    Country              |    US
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    Telephone            |    918-880-3937
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    Fax                  |    918-539-0030
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Authorized Official
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    Title or Position    |    DIRECTOR
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    Name                 |    DR. KIMBERLY D DUROSSETTE 
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    Credential           |    OD
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    Telephone            |    918-869-1940
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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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