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General NPI Number Information
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NPI Number | 1891952453
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Entity Type | Organization
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Legal Business Name | JACQUELYN POWERS OD PC
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Dates
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Enumeration Date | 05/21/2008
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Last Update Date | 12/07/2023
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Provider Practice Location Address
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Address Line | 3539 W MAIN ST
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City | NORMAN
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State | OK
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Zip | 73072-4811
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Country | US
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Telephone | 185-275-2109
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Fax |
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Provider Business Mailing Address
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Address Line | 3539 W MAIN ST
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City | NORMAN
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State | OK
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Zip | 73072-4811
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Country | US
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Telephone | 918-527-5210
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Fax | 405-364-3269
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Authorized Official
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Title or Position | OWNER
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Name | JACQUELYN POWERS
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Credential |
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Telephone | 918-527-5210
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WP0200X
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Taxonomy Name | Pediatric Optometrist
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License Number | 2496
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 152WV0400X
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Taxonomy Name | Vision Therapy Optometrist
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License Number | 2496
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License Number State | OK
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2496
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License Number State | OK
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