Organization
FAMILY EYE CARE OF SHAWNEE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIRK F HOSTER OD (PARTNER)
(405) 275-2020
Entity
Organization
Contact information
Practice address
2109 N KICKAPOO AVE, SHAWNEE, OK 74804-2732
(405) 275-2020
(405) 275-4129
Mailing address
2109 N KICKAPOO AVE, SHAWNEE, OK 74804-2732
(405) 275-2020
(405) 275-4129
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0577720001
PALMETTO
OK
05
—
100764300A
—
OK
05
—
200463520A
—
OK
01
—
731350800001
BCBS
OK
Enumeration date
01/08/2015
Last updated
11/11/2016
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