Organization
POAGE EYECARE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. REBECCA LYNN POAGE OD (OWNER)
(405) 256-0126
Entity
Organization
Contact information
Practice address
1432 N MUSTANG RD, MUSTANG, OK 73064-7214
(405) 256-0126
(405) 256-0563
Mailing address
1432 N MUSTANG RD, MUSTANG, OK 73064-7214
(405) 256-0126
(405) 256-0563
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2430
OK
152WC0802X
Corneal and Contact Management Optometrist
2430
OK
152WL0500X
Low Vision Rehabilitation Optometrist
2430
OK
152WP0200X
Pediatric Optometrist
2430
OK
332H00000X
Eyewear Supplier
2430
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20006384830A
—
OK
Enumeration date
12/21/2006
Last updated
06/13/2024
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