Organization
SCOTT M. CARLSON OD PC
Active
Other names
Advantage Eyecare
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KRISTIE CARLSON (PRACTICE ADMINISTRATOR)
(580) 233-8200
Entity
Organization
Contact information
Practice address
506 S CLEVELAND ST, ENID, OK 73703-5523
(580) 233-8200
(580) 233-7510
Mailing address
506 S CLEVELAND ST, ENID, OK 73703-5523
(580) 233-8200
(580) 233-7510
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2211
OK
152WC0802X
Corneal and Contact Management Optometrist
2211
OK
152WP0200X
Pediatric Optometrist
2211
OK
152WS0006X
Sports Vision Optometrist
2211
OK
156FX1201X
Optometric Assistant Technician
2211
OK
156FX1800X
Optician
2211
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100749000A
—
OK
05
—
100767350A
—
OK
01
—
5196410001
DMERC
OK
Enumeration date
03/02/2007
Last updated
02/06/2018
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