=====================================================
General NPI Number Information
=====================================================
NPI Number | 1659376853
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | WILLIAM A STUEVER O.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/15/2005
-----------------------------------------------------
Last Update Date | 08/21/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1619 N 5TH ST
-----------------------------------------------------
City | PONCA CITY
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 74601-2703
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 580-762-5700
-----------------------------------------------------
Fax | 580-765-3022
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1619 N 5TH ST
-----------------------------------------------------
City | PONCA CITY
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 74601-2703
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 580-762-5700
-----------------------------------------------------
Fax | 580-765-3022
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152WL0500X
-----------------------------------------------------
Taxonomy Name | Low Vision Rehabilitation Optometrist
-----------------------------------------------------
License Number | OK2144
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 152WP0200X
-----------------------------------------------------
Taxonomy Name | Pediatric Optometrist
-----------------------------------------------------
License Number | OK2144
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 152WC0802X
-----------------------------------------------------
Taxonomy Name | Corneal and Contact Management Optometrist
-----------------------------------------------------
License Number | OK2144
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 152WS0006X
-----------------------------------------------------
Taxonomy Name | Sports Vision Optometrist
-----------------------------------------------------
License Number | OK2144
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------
Taxonomy #5
-----------------------------------------------------
Taxonomy Code | 152WX0102X
-----------------------------------------------------
Taxonomy Name | Occupational Vision Optometrist
-----------------------------------------------------
License Number | OK2144
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------
Taxonomy #6
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | 2144
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------