Organization
SAMUEL C. OLIPHANT, INC
Active
Other names
Vision Source
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMUEL CURTIS OLIPHANT JR. O.D. (PRESIDENT)
(405) 751-7727
Entity
Organization
Contact information
Practice address
14000 QUAILBROOK DR, OKLAHOMA CITY, OK 73134-1701
(405) 751-7727
(405) 755-1875
Mailing address
14000 QUAILBROOK DR, OKLAHOMA CITY, OK 73134-1701
(405) 751-7727
(405) 755-1875
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
898
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1033244033
NPI, GROUP
OK
01
—
1396750139
NPI INDIVIDUAL
OK
01
—
410022654
RR MEDICARE
OK
Enumeration date
02/22/2007
Last updated
07/01/2010
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