Vision Source of Liberal Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

1366-3 Issued in KS

Legal business name

VISION SOURCE OF LIBERAL INC

Practice address

621 E Stevens St
Elkhart, KS 67950-7709

Phone

(620) 697-1244

Fax

(620) 697-4197

NPI assigned

Feb 21, 2013

Last updated

Feb 21, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Steven D Graham, OD

Title

Optometrist

Phone

(620) 624-3841

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1361404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361404800000",
    "number": "1821338229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2136 N KANSAS AVE",
            "city": "LIBERAL",
            "state": "KS",
            "postal_code": "679012012",
            "telephone_number": "620-624-3841",
            "fax_number": "620-624-3841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 E STEVENS ST",
            "city": "ELKHART",
            "state": "KS",
            "postal_code": "679507709",
            "telephone_number": "620-697-1244",
            "fax_number": "620-697-4197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISION SOURCE OF LIBERAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-21",
        "last_updated": "2013-02-21",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "620-624-3841",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1366-3",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Elkhart, KS
• Providers in Elkhart, KS by specialty
• Optometrist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2013; 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.