Organization
NATHANIEL D EDWARDS OD PLLC
Active
Other names
Edwards Family Vision
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NATHANIEL D EDWARDS OD (MANAGER)
(580) 255-1172
Entity
Organization
Contact information
Practice address
1619 W ELK AVE, DUNCAN, OK 73533-1725
(580) 255-1172
(580) 255-1234
Mailing address
1619 W ELK AVE, DUNCAN, OK 73533-1725
(580) 255-1172
(580) 255-1234
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2845
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200600380A
—
OK
Enumeration date
08/10/2015
Last updated
08/31/2015
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