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Individual

DR. WALTER PRESLEY MEGOWN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
916 E 8TH ST, OKMULGEE, OK 74447-4724
(918) 756-2124
(918) 756-3865
Mailing address
PO BOX 610, OKMULGEE, OK 74447-0610
(918) 756-2124
(918) 756-3865

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OK880
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100761970A
OK
01
410038339
RAILROAD MEDICARE PTAN
OK
01
730950703001
BC/BS
Enumeration date
12/15/2006
Last updated
02/11/2013
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