Organization
WALT P. MEGOWN OD INC.
Active
Other names
Okmulgee Vision Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WALT P MEGOWN OD (OWNER)
(918) 756-2124
Entity
Organization
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
880
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100730920B
—
OK
01
—
730950703001
BCBS
—
Enumeration date
12/28/2006
Last updated
11/17/2011
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