| Dr Lisa Marie Kedzuf-mcginnis, OD | |
|
107 S Broadway St, Cleveland, OK 74020-4614 | |
| (918) 358-2245 | |
| Not Available |
| Full Name | Dr Lisa Marie Kedzuf-mcginnis |
|---|---|
| Gender | Female |
| Speciality | Optometrist |
| Location | 107 S Broadway St, Cleveland, Oklahoma |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134216609 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 2477 (Oklahoma) | Primary |
| Provider Name | Kedzymac Enterprises Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1376272369 PECOS PAC ID: 5890175798 Enrollment ID: O20220709000675 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Lisa Marie Kedzuf-mcginnis, OD 9318 Scarlet Oak Dr, Sand Springs, OK 74063-3901 Ph: (918) 520-4344 | Dr Lisa Marie Kedzuf-mcginnis, OD 107 S Broadway St, Cleveland, OK 74020-4614 Ph: (918) 358-2245 |
Kedzymac Enterprises, Llc Optometrist Medicare: Medicare Enrolled Practice Location: 107 S Broadway St, Cleveland, OK 74020 Phone: 918-385-2245 | |
Dr. Gregory A. Fielding , P.c. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 107 S Broadway St, Cleveland, OK 74020 Phone: 918-358-2245 Fax: 918-358-5230 | |
Mr. Gregory Allen Fielding, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 107 South Broadway, Cleveland, OK 74020 Phone: 918-358-2245 Fax: 918-358-5230 |