Mark a. Manahan, O.D., Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

962 Issued in OK

Legal business name

MARK A. MANAHAN, O.D., INC

Practice address

305 E Broadway St
Sand Springs, OK 74063-7910

Phone

(918) 245-2020

Fax

(918) 245-2010

NPI assigned

Feb 27, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Mark Arlen Manahan, O.D.

Title

Optometric Physician-Owner

Phone

(918) 245-2020

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301356800000",
    "number": "1568599496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 E BROADWAY ST",
            "city": "SAND SPRINGS",
            "state": "OK",
            "postal_code": "740637910",
            "telephone_number": "918-245-2020",
            "fax_number": "918-245-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 E BROADWAY ST",
            "city": "SAND SPRINGS",
            "state": "OK",
            "postal_code": "740637910",
            "telephone_number": "918-245-2020",
            "fax_number": "918-245-2010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK A. MANAHAN, O.D., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2011-03-29",
        "status": "A",
        "authorized_official_last_name": "MANAHAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "ARLEN",
        "authorized_official_title_or_position": "OPTOMETRIC PHYSICIAN-OWNER",
        "authorized_official_telephone_number": "918-245-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OK",
            "license": "962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410020609",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100765990A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William Ludlow
• Savannah Marie Lytle
• Chelseajo Machado, COTA
• Bryan Hossein Maeen, B.A.
• Mark A Manahan, O. D.
• Janice Elaine Marr, LCSW
• Eric Martin
• Mary Matkin, LPC, LADC
• Mays Drug Stores Inc
• Wendy McConnell, M.D.

• Optometrist in Sand Springs, OK
• Providers in Sand Springs, OK by specialty
• Optometrist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2011; 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.