Organization
EYE CARE SPECIALISTS OF OKLAHOMA PLLC
Active
Organization
EYE CARE SPECIALISTS OF OKLAHOMA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JARED R JACKSON MD (PROVIDER)
(405) 771-0880
Entity
Organization
Contact information
Practice address
3431 S BOULEVARD STE 105, EDMOND, OK 73013
(405) 562-2036
(405) 562-2116
Mailing address
PO BOX 1803, EDMOND, OK 73083-1803
(405) 418-4800
(405) 418-4820
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
29168
OK
261QM2500X
Medical Specialty Clinic/Center
—
—
261QS0132X
Ophthalmologic Surgery Clinic/Center
—
—
Other
Enumeration date
01/29/2018
Last updated
04/21/2020
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