Organization
MCIVER VISION CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANN L MCIVER O.D. (OPTOMETRIST)
(580) 276-5548
Entity
Organization
Contact information
Practice address
112 W MAIN ST, SUITE A-1, MARIETTA, OK 73448-2847
(580) 276-5548
(580) 276-5541
Mailing address
PO BOX 267, MARIETTA, OK 73448-0267
(580) 276-5548
(580) 276-5541
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2139
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
248404404
BLUE CROSS BLUE SHIELD
OK
Enumeration date
06/27/2007
Last updated
03/01/2010
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