MEDICARE: CENTRAL OKLAHOMA EYE ASSOCIATES, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	18051	OK

General Provider Information

NPI Number	:	1265492581
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRAL OKLAHOMA EYE ASSOCIATES, P.C.

Provider Business Mailing Address
First Line	:	5701 N PORTLAND AVE
Second Line	:	SUITE 105
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-1670
Country	:	US
Telephone Number	:	405-949-6401
Fax Number	:	405-949-4283

Provider Business Practice Location Address
First Line	:	5701 N PORTLAND AVE
Second Line	:	SUITE 105
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-1670
Country	:	US
Telephone Number	:	405-949-6401
Fax Number	:	405-949-4283

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. EDWARD D JONES
Credential	:	M.D.
Telephone Number	:	405-949-6401

Provider Enumeration Date	:	03/23/2006
Last Update Date	:	08/12/2013

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