Individual
CHAD J EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
12455 E 100TH ST N # 110, OWASSO, OK 74055-4600
(918) 274-7100
(918) 584-4479
Mailing address
12455 E 100TH ST N # 110, OWASSO, OK 74055-4600
(918) 274-7100
(918) 584-4479
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2300
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100763950A
—
OK
Enumeration date
07/26/2006
Last updated
12/01/2010
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