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General NPI Number Information
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NPI Number | 1710025697
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Entity Type | Organization
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Legal Business Name | LEN D. HART, P.C.
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Dates
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Enumeration Date | 02/02/2007
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Last Update Date | 04/30/2008
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Provider Practice Location Address
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Address Line | 1103 W CENTER ST
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City | COLLINSVILLE
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State | OK
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Zip | 74021-3108
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Country | US
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Telephone | 918-371-3339
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Fax | 918-371-9600
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Provider Business Mailing Address
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Address Line | PO BOX 640
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City | COLLINSVILLE
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State | OK
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Zip | 74021-0640
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Country | US
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Telephone | 918-371-3339
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Fax | 918-371-9600
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Authorized Official
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Title or Position | OWNER
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Name | DR. LEN D. HART
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Credential | O.D.
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Telephone | 918-371-3339
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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 | 981
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License Number State | OK
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