Individual
DR. JOHN D KASTL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
4901 N KICKAPOO AVE, SUITE#1606, SHAWNEE, OK 74804-1303
(405) 273-5014
(405) 273-5014
Mailing address
4901 N KICKAPOO AVE, SUITE#1606, SHAWNEE, OK 74804-1303
(405) 273-5014
(405) 273-5014
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OK936
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OK936
STATE LICENSE NUMBER
OK
Enumeration date
11/22/2006
Last updated
07/08/2007
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