Individual
DR. HAYDEN DEAN BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
900 W MAIN ST, HENRYETTA, OK 74437-4252
(918) 652-2345
Mailing address
611 W LOUISE ST, HENRYETTA, OK 74437-6243
(918) 284-0164
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3112
OK
Other
Enumeration date
06/29/2021
Last updated
10/06/2021
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