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General NPI Number Information
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NPI Number | 1437245750
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Entity Type | Organization
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Legal Business Name | DOBBS EYE CLINIC, INC.
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 05/13/2008
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Provider Practice Location Address
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Address Line | 603 W CHEROKEE AVE
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City | SALLISAW
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State | OK
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Zip | 74955-4213
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Country | US
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Telephone | 918-775-5529
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Fax | 918-775-0515
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Provider Business Mailing Address
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Address Line | 603 W CHEROKEE AVE
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City | SALLISAW
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State | OK
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Zip | 74955-4213
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Country | US
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Telephone | 918-775-5529
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Fax | 918-775-0515
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Authorized Official
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Title or Position | OPTOMETRIST/OWNER/PRESIDENT
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Name | DR. WYATT ZANE DOBBS
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Credential | O.D.
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Telephone | 918-775-5529
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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 | 1019
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License Number State | OK
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