Organization
WARREN EYE CARE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARCIA LADAWN WARREN OD (OPTOMETRIST/OWNER)
(405) 376-5444
Entity
Organization
Contact information
Practice address
100 S CASTLEROCK LN, MUSTANG, OK 73064-4586
(405) 376-5444
Mailing address
100 S CASTLEROCK LN, MUSTANG, OK 73064-4586
(405) 376-5444
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OK2353
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00959625
PPO OKLAHOMA
OK
01
—
445828805003
BLUE CROSS BLUE SHIELD
OK
01
—
7603576
AETNA
OK
Enumeration date
10/17/2006
Last updated
10/18/2007
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