=====================================================
General NPI Number Information
=====================================================
NPI Number | 1871923458
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PRECISION VISION OF EDMOND, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/19/2013
-----------------------------------------------------
Last Update Date | 03/18/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 200 W COVELL RD
-----------------------------------------------------
City | EDMOND
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73003-2346
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 405-341-2062
-----------------------------------------------------
Fax | 405-341-6553
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 200 W COVELL RD
-----------------------------------------------------
City | EDMOND
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73003-2346
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 405-341-2062
-----------------------------------------------------
Fax | 405-341-6553
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. SELINA MCGEE
-----------------------------------------------------
Credential | OD
-----------------------------------------------------
Telephone | 405-341-2062
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | 2367
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------