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Organization

JEFFREY L. BURCHAM, OPTOMETRIST, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JEFFREY L. BURCHAM O.D. (OPTOMETRIST)
(405) 364-2020
Entity
Organization

Contact information

Practice address
444 24TH AVE SW, NORMAN, OK 73069-5110
(405) 364-2020
(405) 364-2021
Mailing address
444 24TH AVE SW, NORMAN, OK 73069-5110
(405) 364-2020
(405) 364-2021

Taxonomy

Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
152W00000X
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100763530
OK
Enumeration date
01/06/2009
Last updated
10/22/2009
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