Organization
BROADWAY VISION ASSOCIATES, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CANDACE Y. STEWART OD (OD OWNER)
(918) 687-4459
Entity
Organization
Contact information
Practice address
435 W BROADWAY ST, MUSKOGEE, OK 74401-6614
(918) 687-4459
(918) 687-0238
Mailing address
435 W BROADWAY ST, MUSKOGEE, OK 74401-6614
(918) 687-4459
(918) 687-0238
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
332H00000X
Eyewear Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100739020A
—
OK
Enumeration date
03/29/2007
Last updated
02/18/2010
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