Organization
BOGARDUS VISION CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARL ROBERT BOGARDUS (OWNER)
(405) 681-4500
Entity
Organization
Contact information
Practice address
2200 SW 74TH ST, SUITE 102, OKLAHOMA CITY, OK 73159-3928
(405) 681-4500
(405) 681-0038
Mailing address
2200 SW 74TH ST, SUITE 102, OKLAHOMA CITY, OK 73159-3928
(405) 681-4500
(405) 681-0038
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1042
OK
Other
Enumeration date
05/01/2012
Last updated
06/04/2012
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