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Organization

MARC A GOLDBERG MD PC

Active
Parent organization
MARC A GOLDBERG, MD PC
Other names
Marc A Goldberg MD Optical
Organization subpart
Yes

Provider details

NPI number
Legal business name
MARC A GOLDBERG, MD PC
Authorized official
DR. MARC ANDREW GOLDBERG MD (OWNER)
(918) 712-3256
Entity
Organization

Contact information

Practice address
2000 S WHEELING AVE, SUITE 1010, TULSA, OK 74104-5649
(918) 712-3256
(918) 712-3263
Mailing address
2000 S WHEELING AVE, SUITE 1010, TULSA, OK 74104-5649
(918) 712-3256
(918) 712-3263

Taxonomy

Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
332H0000X
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100198360A
OK
Enumeration date
07/19/2010
Last updated
10/29/2010
Update your record

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