Individual
DR. CHRISTOPHER RAY CHENOWETH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
502 E PROSPECT AVE, PONCA CITY, OK 74601-7404
(580) 765-7509
(580) 765-2886
Mailing address
502 E PROSPECT AVE, PONCA CITY, OK 74601-7404
(580) 765-7509
(580) 765-2886
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2154
OK
152WC0802X
Corneal and Contact Management Optometrist
2154
OK
152WP0200X
Pediatric Optometrist
2154
OK
152WS0006X
Sports Vision Optometrist
2154
OK
332H00000X
Eyewear Supplier
2154
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100744700A
—
OK
Enumeration date
07/19/2006
Last updated
12/05/2022
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