Individual
DR. LELAND CARR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1001 N GRAND AVE, TAHLEQUAH, OK 74464-7017
(918) 458-2109
(918) 458-2310
Mailing address
1001 N GRAND AVE, TAHLEQUAH, OK 74464-7017
(918) 456-5511
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1102
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200081250A
—
OK
Enumeration date
10/31/2005
Last updated
01/06/2012
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