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General NPI Number Information
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NPI Number | 1659557098
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Entity Type | Organization
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Legal Business Name | HAILEY KANARD O.D.
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Dates
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Enumeration Date | 01/16/2008
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Last Update Date | 11/03/2014
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Provider Practice Location Address
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Address Line | 404 E WYANDOTTE AVE
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City | MCALESTER
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State | OK
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Zip | 74501-5464
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Country | US
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Telephone | 918-426-0728
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Fax | 918-426-0740
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Provider Business Mailing Address
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Address Line | 404 E WYANDOTTE AVE
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City | MCALESTER
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State | OK
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Zip | 74501-5464
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Country | US
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Telephone | 918-426-0728
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Fax | 918-426-0740
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Authorized Official
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Title or Position | OWNER
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Name | DR. THOMAS HAILEY KANARD
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Credential | O.D.
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Telephone | 918-426-0728
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | 843
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License Number State | OK
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