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General NPI Number Information
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NPI Number | 1891339107
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Entity Type | Organization
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Legal Business Name | ADVANCED EYECARE SOLUTIONS PLLC
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Dates
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Enumeration Date | 10/30/2019
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Last Update Date | 05/09/2025
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Provider Practice Location Address
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Address Line | 617 S MAIN ST
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City | STILLWATER
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State | OK
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Zip | 74074-4060
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Country | US
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Telephone | 405-372-7337
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2376
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City | STILLWATER
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State | OK
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Zip | 74076-2376
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Country | US
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Telephone | 405-372-7337
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. MARSHALL WALKER
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Credential | OD
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Telephone | 918-978-2551
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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 |
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License Number State |
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