Active NPI
Ronald Edward Sellers, OD
- Optometrist
- Lawton, OK
National Provider Identifier
1124027313
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 12023
- Practice address
- 1515 Lawrie Tatum Rd
Lawton, OK 73507 - Phone
- (580) 353-0350
- Fax
- (580) 355-6234
- NPI assigned
- Jul 19, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 12023 | KS | Primary |
Addresses
Primary practice location
1515 Lawrie Tatum Rd
Lawton, OK 73507
Mailing address
1515 Lawrie Tatum Rd
Lawton, OK 73507
Phone (580) 353-0350
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| S2592 | Medicaid | NM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12023 | KS | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121731200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204243200000",
"number": "1124027313",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1515 LAWRIE TATUM RD",
"city": "LAWTON",
"state": "OK",
"postal_code": "73507",
"telephone_number": "580-353-0350",
"fax_number": "580-355-6234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1515 LAWRIE TATUM RD",
"city": "LAWTON",
"state": "OK",
"postal_code": "73507",
"telephone_number": "580-353-0350",
"fax_number": "580-355-6234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SELLERS",
"first_name": "RONALD",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-19",
"last_updated": "2008-02-29",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "KS",
"license": "12023",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "S2592",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lawton, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 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.