DRS Hiskett Elliott & Cantrell
Organization Active NPI Optometrist · Bristow, OK
NPI 1497932412 · NPPES record last updated Feb 12, 2009
Key facts
- NPI
- 1497932412
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- Legal business name
- DRS HISKETT ELLIOTT & CANTRELL
- Practice address
- 121 E 7TH
Bristow, OK 74010-2501 - Phone
- (918) 367-2020
- Fax
- (918) 367-9542
- NPI assigned
- Jan 22, 2008
- Organization subpart
- No
Authorized official
- Name
- Dr. Zeddie Cantrell Jr., OD
- Title
- Manager
- Phone
- (918) 367-2020
Practitioners 3
-
Zeddie L Cantrell Jr., O.D.
-
Kathleen F Elliott, O.D.
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Vision Source |
Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses | Accepts assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in OK
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080710000518 | OK | Part B Supplier - Clinic/Group Practice | 2567534316 |
Receives reassigned benefits from 1 practitioner Practice locations: Bristow, OK |
| O20100930005411 | OK | DME Supplier - Physician - Optometrist | 2567534316 | Practice locations: Bristow, OK |
National Provider Directory
Locations
121 E 7th Ave
Bristow, OK 74010
Phone (580) 332-1880
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | OK | Yes |
Addresses
Primary practice location
121 E 7TH
Bristow, OK 74010-2501
Mailing address
PO Box 719
Bristow, OK 74010-0719
Phone (918) 367-2020
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100761340A | Medicaid | OK |
Other providers in Bristow, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 12, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.