Individual
ISHANI PATEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
409 SW C AVE, LAWTON, OK 73501-4017
(270) 415-0245
(580) 248-4500
Mailing address
1130 LONE OAK RD, PADUCAH, KY 42003-4525
(270) 415-0245
(270) 415-0248
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
2269DT
KY
152W00000X
Optometrist
Primary
3237
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100818190
—
KY
Enumeration date
06/07/2022
Last updated
04/03/2024
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