Cameron Eugene Herrin, O.D.
Individual provider Active NPI Optometrist · Purcell, OK
NPI 1902865744 · NPPES record last updated Oct 27, 2011
Key facts
- NPI
- 1902865744
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 2246 (OK)
- Practice address
- 1711 N Green Ave.
Purcell, OK 73080-4220 - Phone
- (405) 527-2020
- Fax
- (405) 527-0318
- NPI assigned
- Mar 21, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2246 | OK | MD | Optometrist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2246 | OK | Yes |
Addresses
Primary practice location
1711 N Green Ave.
Purcell, OK 73080-4220
Mailing address
1711 N Green Ave.
Purcell, OK 73080-4220
Phone (405) 527-2020
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 410042651 | Other | OK | RAILROAD MEDICARE |
| 100764590A | Medicaid | OK | |
| 731546546 | Other | OK | HEALTHCHOICE |
Other providers in Purcell, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 27, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.