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Organization

RIVERSIDE EYE CLINIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. TAMMY M SCHEFF-PAUL OD (OWNER)
(918) 296-4733
Entity
Organization

Contact information

Practice address
524 E MAIN ST, JENKS, OK 74037-4137
(918) 296-4733
(918) 296-4734
Mailing address
524 E MAIN ST, JENKS, OK 74037-4137
(918) 296-4733
(918) 296-4734

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2205
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200004890A
OK
01
3171770001
DMERC
OK
Enumeration date
10/01/2008
Last updated
10/01/2008
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