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Organization

GERALD W. GRAEFE ODINC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GERALD W GRAEFE OD (OWNER)
(918) 664-1180
Entity
Organization

Contact information

Practice address
2310 S GARNETT RD, TULSA, OK 74129-5110
(918) 664-1180
(918) 627-0359
Mailing address
2310 S GARNETT RD, TULSA, OK 74129-5110
(918) 664-1180
(918) 627-0359

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
837
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100252590A
OK
Enumeration date
03/28/2007
Last updated
12/28/2011
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