| NPI | 1427556166 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JARED R JACKSON Provider 405-771-0880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OK 29168) |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty |
| 261QS0132X Clinic/Center, Ophthalmologic Surgery | |
| Enumeration Date | 2018-01-29 |
| Last Update Date | 2020-04-21 |