Organization
GLENN E. PARTIN OD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GLENN E PARTIN O.D. (DOCTOR/OWNER)
(405) 376-9779
Entity
Organization
Contact information
Practice address
1100 N MUSTANG RD, MUSTANG, OK 73064-7201
(405) 376-9779
(405) 376-9668
Mailing address
1100 N MUSTANG RD, MUSTANG, OK 73064-7201
(405) 376-9779
(405) 376-9668
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1092
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100759930A
—
OK
01
—
410048385
RAILROAD MEDICARE
OK
Enumeration date
01/29/2008
Last updated
02/23/2009
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