Individual
DR. ROGER LEE RADELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
915 9TH STREET, PRAGUE, OK 74864-0507
(405) 567-2261
Mailing address
PO BOX 507, PRAGUE, OK 74864-0507
(405) 567-2261
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2024
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100766660A
—
OK
01
—
1265539613
NPI
—
Enumeration date
09/20/2006
Last updated
04/01/2016
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