Organization
GORE EYE CLINIC PLLC
Active
Other names
Gore Eye Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONI SUE RUSSELL OD (OPTOMETRIST)
(918) 489-2512
Entity
Organization
Contact information
Practice address
202 N MAIN, GORE, OK 74435
(918) 489-2512
Mailing address
PO BOX 712, GORE, OK 74435-0712
(918) 489-2512
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
2470
OK
Other
Enumeration date
08/06/2009
Last updated
01/07/2011
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