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General NPI Number Information
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NPI Number | 1790990059
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Entity Type | Organization
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Legal Business Name | OCULOPLASTIC SURGEONS OF OKLAHOMA, PLLC
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Dates
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Enumeration Date | 05/11/2007
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Last Update Date | 12/29/2016
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Provider Practice Location Address
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Address Line | 16315 N MAY AVE
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City | EDMOND
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State | OK
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Zip | 73013-8892
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Country | US
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Telephone | 405-521-0041
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Fax | 405-521-1689
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Provider Business Mailing Address
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Address Line | 16315 N MAY AVE
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City | EDMOND
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State | OK
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Zip | 73013-8892
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Country | US
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Telephone | 405-521-0041
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Fax | 405-521-1689
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Authorized Official
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Title or Position | MANAGER
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Name | DR. ERIN L HOLLOMAN
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Credential | M.D.
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Telephone | 405-521-0041
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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