MEDICARE: DR. CARL WADE NEWTON O.D.

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	152W00000X	Optometrist	1056	OK
2	152WC0802X	Corneal and Contact Management Optometrist	1056	OK
3	152WL0500X	Low Vision Rehabilitation Optometrist	1056	OK
4	152WP0200X	Pediatric Optometrist	1056	OK
5	152WS0006X	Sports Vision Optometrist	1056	OK
6	152WV0400X	Vision Therapy Optometrist	1056	OK
7	152WX0102X	Occupational Vision Optometrist	1056	OK

General Provider Information

NPI Number	:	1548257074
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARL WADE NEWTON O.D.

Provider Business Mailing Address
First Line	:	1504 S GRAND AVE
Second Line	:	POB 264
City	:	CHEROKEE
State	:	OK
Zip	:	73728-4529
Country	:	US
Telephone Number	:	580-596-3573
Fax Number	:	580-596-3937

Provider Business Practice Location Address
First Line	:	1504 S GRAND AVE
Second Line	:	POB 264
City	:	CHEROKEE
State	:	OK
Zip	:	73728-4529
Country	:	US
Telephone Number	:	580-596-3573
Fax Number	:	580-596-3937

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/30/2005
Last Update Date	:	09/11/2025

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