Individual provider · NPI-1
Dr. Scott Michael Carlson, O.D.
Optometrist · Skiatook, OK
NPI number1235243544
StatusActive
Last updated in NPPESMar 1, 2017
Details
- NPI
- 1235243544
- Entity type
- Individual (NPI-1)
- Name
- Dr. Scott Michael Carlson
- Credential
- O.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Aug 17, 2006
- Last updated
- Mar 1, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | 2211 | OK | Yes |
| 152WC0802X | Optometrist, Corneal and Contact Management | 2211 | OK |
Practice location
5335 W Rogers BlvdSte B
Skiatook, OK 74070-5285
Phone 198-396-4440 · Fax 918-396-4449
Mailing address
506 S Cleveland StSte B
Enid, OK 73703-5523
Phone 580-233-8200 · Fax 580-233-8200
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.