Individual
JON E PAINTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
619 N BROADWAY ST, MOORE, OK 73160-4813
(405) 799-7706
(405) 799-7715
Mailing address
619 N BROADWAY ST, MOORE, OK 73160-4813
(405) 799-7706
(405) 799-7715
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2048
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100762190A
—
OK
01
—
441729242001
BC/BS OK
OK
Enumeration date
08/12/2006
Last updated
09/01/2010
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