Organization
J DEAN NOLAN OD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEAN NOLAN OD (OWNER)
(580) 353-2015
Entity
Organization
Contact information
Practice address
3414 NW CACHE RD STE E, LAWTON, OK 73505-3877
(580) 353-2015
(580) 353-2022
Mailing address
3414 NW CACHE RD STE E, LAWTON, OK 73505-3877
(580) 353-2015
(580) 353-2022
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1091
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100765020A
—
OK
01
—
1558379669
TRICARE
OK
01
—
OKB5156
MEDICARE PTAN
—
Enumeration date
04/15/2008
Last updated
02/17/2012
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