Individual
DR. MITCHELL RAY ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
8215 S MINGO RD STE 100, TULSA, OK 74133-4671
(918) 252-7432
(918) 250-9003
Mailing address
1950 OLD GALLOWS RD STE 520, VIENNA, VA 22182-3970
(703) 847-8899
(571) 223-6780
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1069
OK
152WC0802X
Corneal and Contact Management Optometrist
1069
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
112326
EYEMED
OK
01
—
1598881534
BCBS OF OKLAHOMA
OK
01
—
274812801
FEDERAL ID
OK
01
—
3518
SUPERIOR VISION
OK
01
—
9184554545
VSP
OK
01
—
9745
AVESIS
OK
01
—
ANDE23832
SPECTERA
OK
Enumeration date
03/21/2007
Last updated
11/02/2023
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