Organization
JON E. PAINTER O.D.,P.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JON E PAINTER O.D. (OWNER)
(405) 799-7706
Entity
Organization
Contact information
Practice address
619 N BROADWAY ST, MOORE, OK 73160-4813
(405) 799-7706
(405) 799-7715
Mailing address
619 N. BROADWAY ST., MOORE, OK 73160
(405) 799-7706
(405) 799-7715
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2048
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0526790001
PROVIDER ID
OK
05
—
100762190A
—
OK
Enumeration date
04/17/2007
Last updated
09/01/2010
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