MEDICARE: DRS HIGGS & MORRIS OPTOMETRISTS INC

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	844	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	OKB5565	OTHER	OK	PTAN

General Provider Information

NPI Number	:	1578682647
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DRS HIGGS & MORRIS OPTOMETRISTS INC

Provider Business Mailing Address
First Line	:	17 S OAK ST
Second Line	:
City	:	SAPULPA
State	:	OK
Zip	:	74066-4312
Country	:	US
Telephone Number	:	918-224-2610
Fax Number	:	918-224-0613

Provider Business Practice Location Address
First Line	:	17 S OAK ST
Second Line	:
City	:	SAPULPA
State	:	OK
Zip	:	74066-4312
Country	:	US
Telephone Number	:	918-224-2610
Fax Number	:	918-224-0613

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. LARRY WAYNE HIGGS
Credential	:	O.D.
Telephone Number	:	918-224-2610

Provider Enumeration Date	:	03/28/2007
Last Update Date	:	06/11/2009

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