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NPI Code Detail

MEDICARE: TECUMSEH EYE ASSOCIATES PLLC

MEDICARE: TECUMSEH EYE ASSOCIATES PLLC
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
1152W00000XOptometrist

General Provider Information

NPI Number : 1578991758
Entity Type Code : Organization
Provider Name (Legal Business Name) : TECUMSEH EYE ASSOCIATES PLLC
Provider Business Mailing Address
First Line : 123 E WASHINGTON ST
Second Line :
City : TECUMSEH
State : OK
Zip : 74873-3241
Country : US
Telephone Number : 405-598-6558
Fax Number : 405-598-2202
Provider Business Practice Location Address
First Line : 123 E WASHINGTON ST
Second Line :
City : TECUMSEH
State : OK
Zip : 74873-3241
Country : US
Telephone Number : 405-598-6558
Fax Number : 405-598-2202
Authorized Official
Title or Position : OWNER/OD
Name : KYLE K KARNISH
Credential : OD
Telephone Number : 405-598-6558
Provider Enumeration Date : 10/24/2013
Last Update Date : 10/24/2013

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Directions to “TECUMSEH EYE ASSOCIATES PLLC ” Practice Location

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