Organization
TRIAD SURGERY CENTER LLC
Active
Other names
Triad Eye Institute, Triad Eye Medical Clinic And Cataract Institute PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN PATRICK CONLEY (OWNER/MANAGER)
(918) 687-6600
Entity
Organization
Contact information
Practice address
3131 MILITARY BLVD, MUSKOGEE, OK 74401-2290
(918) 687-6600
(918) 687-6610
Mailing address
6140 S MEMORIAL DR, TULSA, OK 74133-1933
(918) 252-2020
(918) 307-1983
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
0061
OK
261QA1903X
Ambulatory Surgical Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100738620C
—
OK
01
—
490004258
MEDICARE ID
OK
01
—
CO5028
RAILROAD MEDICARE
OK
Enumeration date
06/28/2005
Last updated
06/26/2019
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