Organization
PHILLIP D GRIMES P C
Active
Other names
Phillip D. Grimes, O.D.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHILLIP DON GRIMES O.D. (PRESIDENT)
(405) 376-2429
Entity
Organization
Contact information
Practice address
1108 E. HIGHWAY 152, MUSTANG, OK 73064-5116
(405) 376-2429
(405) 376-2431
Mailing address
1108 E. HIGHWAY 152, MUSTANG, OK 73064-5116
(405) 376-2429
(405) 376-2431
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
845
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
410048647
RAILROAD MEDICARE NSC
OK
Enumeration date
04/17/2007
Last updated
10/13/2011
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