Individual
DR. CAROLYN S EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
602 S 3RD ST, MCALESTER, OK 74501-5822
(918) 423-2031
(918) 423-2115
Mailing address
602 S 3RD ST, MCALESTER, OK 74501-5822
(918) 423-2031
(918) 423-2115
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
933
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100763220 A
—
OK
05
—
100768860B
—
OK
01
—
731175347002
BLUECROSSBLUESHIELD OPTIA
OK
01
—
OKA100394
PTAN
OK
Enumeration date
05/05/2006
Last updated
08/31/2017
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