Individual
GARY R MORGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2061 MAHANEY AVE, TAHLEQUAH, OK 74464-5731
(918) 453-2000
(918) 453-2008
Mailing address
2061 MAHANEY AVE, TAHLEQUAH, OK 74464-5731
(918) 453-2000
(918) 453-2008
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OK925
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100762020A
—
OK
01
—
300522259
MEDICARE PTAN
OK
Enumeration date
10/02/2006
Last updated
07/27/2022
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