Organization
STEVE L SMITH OD PROFESSIONAL CORPORATION
Active
Other names
Primary Eye Care Associates
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LACY N CRISSUP O.D. (VICE-PRESIDENT)
(918) 341-8211
Entity
Organization
Contact information
Practice address
212 E BLUE STARR DR, CLAREMORE, OK 74017-4223
(918) 341-8211
(918) 341-8233
Mailing address
212 E BLUE STARR DR, CLAREMORE, OK 74017-4223
(918) 341-8211
(918) 341-8233
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
870
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100761360A
—
OK
Enumeration date
03/19/2008
Last updated
03/22/2017
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