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General NPI Number Information
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NPI Number | 1740449818
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Entity Type | Organization
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Legal Business Name | TULSA EYE ASSOCIATES, INC., A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 06/04/2008
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Last Update Date | 06/04/2008
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Provider Practice Location Address
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Address Line | 6465 S YALE AVE SUITE 215
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City | TULSA
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State | OK
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Zip | 74136-7823
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Country | US
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Telephone | 918-492-8455
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Fax |
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Provider Business Mailing Address
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Address Line | 6465 S YALE AVE SUITE 215
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City | TULSA
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State | OK
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Zip | 74136-7823
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Country | US
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Telephone | 918-492-8455
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. JAMES F RONK
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Credential | M.D.
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Telephone | 918-492-8455
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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 | 2519
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 18623
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License Number State | OK
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