Individual
DR. SCOTT MICHAEL CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
5335 W ROGERS BLVD, STE B, SKIATOOK, OK 74070-5285
(198) 396-4440
(918) 396-4449
Mailing address
506 S CLEVELAND ST, STE B, ENID, OK 73703-5523
(580) 233-8200
(580) 233-8200
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2211
OK
152WC0802X
Corneal and Contact Management Optometrist
2211
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100767350B
—
OK
Enumeration date
08/17/2006
Last updated
03/01/2017
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