Individual
DOUGLAS BRYANT PEARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
11 S ROWE ST, PRYOR, OK 74361-4626
(918) 825-6144
(918) 825-5374
Mailing address
11 S ROWE ST, PRYOR, OK 74361-4626
(918) 825-6144
(918) 825-5374
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1021
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100761440A
—
OK
01
—
731184882001
BLUECROSS BLUESHIELD
OK
Enumeration date
07/07/2005
Last updated
04/19/2010
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