Organization
MATT GRANTHAM, OD, PC
Active
Other names
Grantham Eye Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DANA M GRANTHAM (OFFICE MANAGER)
(918) 647-9283
Entity
Organization
Contact information
Practice address
101 SMITH AVE STE 2, POTEAU, OK 74953-2613
(918) 647-9283
(918) 649-0878
Mailing address
101 SMITH AVE STE 2, POTEAU, OK 74953-2613
(918) 647-9283
(918) 649-0878
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100851340A
—
OK
05
—
200090590A
—
OK
Enumeration date
01/26/2007
Last updated
07/31/2025
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