| Dr Blake Carlisle, OD | |
|
111 E Broadway, Fairview, OK 73737-2124 | |
| (580) 227-4878 | |
| (580) 227-4666 |
| Full Name | Dr Blake Carlisle |
|---|---|
| Gender | Male |
| Speciality | Optometry |
| Experience | 12 Years |
| Location | 111 E Broadway, Fairview, Oklahoma |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073921524 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 2804 (Oklahoma) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Be Thou My Vision Pc | 5496837957 | 3 |
| Provider Name | Northeastern State University College Of Optometry |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1437106333 PECOS PAC ID: 0941112528 Enrollment ID: O20031103000296 |
| Provider Name | Be Thou My Vision Pc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1225183957 PECOS PAC ID: 5496837957 Enrollment ID: O20080123000668 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Blake Carlisle, OD 111 E Broadway, Fairview, OK 73737-2124 Ph: (580) 227-4878 | Dr Blake Carlisle, OD 111 E Broadway, Fairview, OK 73737-2124 Ph: (580) 227-4878 |
Mr. Max L Carlisle, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 111 E Broadway, Fairview, OK 73737 Phone: 580-227-4878 Fax: 580-227-4666 | |
Be Thou My Vision, Pc Optometrist Medicare: Medicare Enrolled Practice Location: 111 E Broadway, Fairview, OK 73737 Phone: 580-227-4878 Fax: 580-227-4666 | |
Dr. Linda G. Barton, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 103 Cardinal Cir, Fairview, OK 73737 Phone: 580-227-2090 |