Organization
HERITAGE PARK EYE CARE CENTER
Active
Other names
Vision Source Midwest City
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BOB BALDWIN O.D. (OPTOMETRIST)
(405) 732-2277
Entity
Organization
Contact information
Practice address
6912 E RENO AVE, SUITE 101, MIDWEST CITY, OK 73110-2162
(405) 732-2277
(405) 737-4776
Mailing address
6912 E RENO AVE, SUITE 101, MIDWEST CITY, OK 73110-2162
(405) 732-2277
(405) 737-4776
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
758
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CS4518
PALMETTO GROUP #
OK
Enumeration date
03/21/2007
Last updated
08/22/2020
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