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General NPI Number Information
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NPI Number | 1427196146
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Entity Type | Organization
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Legal Business Name | DENISE SPEARS RODDY, OD, PC
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Dates
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Enumeration Date | 02/02/2007
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Last Update Date | 11/24/2015
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Provider Practice Location Address
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Address Line | 6351 E. 67TH PL.
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City | TULSA
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State | OK
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Zip | 74136-3506
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Country | US
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Telephone | 918-497-2002
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Fax | 918-497-2022
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Provider Business Mailing Address
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Address Line | PO BOX 990
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City | JENKS
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State | OK
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Zip | 74037-0990
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Country | US
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Telephone | 918-497-2002
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Fax | 918-497-2022
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DENISE SPEARS RODDY
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Credential | OD
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Telephone | 918-497-2002
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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 | 1185
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License Number State | OK
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