Individual
SCOTT K. MCEACHERN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1220 W WILLOW RD, SUITE B, ENID, OK 73703-2511
(580) 237-4772
Mailing address
1220 W WILLOW RD, SUITE B, ENID, OK 73703-2511
(580) 237-4772
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2138
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100765140A
—
OK
01
—
1175170001
PALMETTO-MEDICARE DURABLE
OK
01
—
410032428
RAILROAD MEDICARE
OK
Enumeration date
10/23/2006
Last updated
07/09/2010
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