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Organization

J D HUDKINS O D INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DANETTE L GUNTER (OFFICE MANAGER)
(918) 455-2020
Entity
Organization

Contact information

Practice address
4008 S ELM PL, SUITE A, BROKEN ARROW, OK 74011-2021
(918) 455-2020
Mailing address
4008 S ELM PL, SUITE A, BROKEN ARROW, OK 74011-2021
(918) 455-2020

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
909
OK
152WC0802X
Corneal and Contact Management Optometrist
909
OK
152WL0500X
Low Vision Rehabilitation Optometrist
909
OK
152WP0200X
Pediatric Optometrist
909
OK
152WS0006X
Sports Vision Optometrist
909
OK
152WX0102X
Occupational Vision Optometrist
909
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100766680A
OK
01
462844000-001
BLUE CROSS BLUE SHIELD
OK
01
E066
BLUELINCS
OK
01
M462844000
COMMUNITY CARE SENIOR
OK
Enumeration date
02/27/2007
Last updated
01/02/2024
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