NPIMap

Organization Active NPI

Northeastern State University College of Optometry

  • Eyewear Supplier
  • Stilwell, OK
National Provider Identifier
1043327778
Registry record updated Jul 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
NORTHEASTERN STATE UNIVERSITY COLLEGE OF OPTOMETRY
Practice address
Route 2 Box 93
Stilwell, OK 74960
Phone
(918) 696-8820
Fax
(918) 696-8882
NPI assigned
Aug 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. George Edward Foster, O.D.
Title
Dean
Phone
(918) 456-5511

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

Route 2 Box 93
Stilwell, OK 74960

Mailing address

1001 N Grand Ave
Tahlequah, OK 74464-7017
Phone (918) 458-2109

National Provider Directory

National Provider Directory
Tax ID family
Northeastern State University College of Optometry7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1001 N Grand Ave
Tahlequah, OK 74464
Phone (918) 456-5511

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215475200000",
    "number": "1043327778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 N GRAND AVE",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744647017",
            "telephone_number": "918-458-2109",
            "fax_number": "918-458-2310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ROUTE 2 BOX 93",
            "city": "STILWELL",
            "state": "OK",
            "postal_code": "74960",
            "telephone_number": "918-696-8820",
            "fax_number": "918-696-8882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEASTERN STATE UNIVERSITY COLLEGE OF OPTOMETRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-25",
        "last_updated": "2008-07-08",
        "status": "A",
        "authorized_official_last_name": "FOSTER",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "DEAN",
        "authorized_official_telephone_number": "918-456-5511",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stilwell, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.