Organization
TULSA VISION CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN BRIAN CHEATHAM O.D. (OPTOMETRIST)
(918) 743-6334
Entity
Organization
Contact information
Practice address
4433 SOUTH HARVARD AVE., TULSA, OK 74135-2604
(918) 743-6334
(918) 743-6369
Mailing address
4433 SOUTH HARVARD AVE., TULSA, OK 74135-2604
(918) 743-6334
(918) 743-6369
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
2356
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200109710A
—
OK
Enumeration date
02/23/2007
Last updated
08/28/2008
Update your record
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