| Henryetta Eye Center | |
|
900 W Main St, Henryetta, OK 74437-4252 | |
| (918) 652-2345 | |
| (918) 652-2537 |
| Full Name | Henryetta Eye Center |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 900 W Main St, Henryetta, Oklahoma |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174727622 | NPI | - | NPPES |
| 200132620A | Medicaid | OK | |
| DN5710 | Other | OK | RAIL ROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (Oklahoma) | Primary |
| Provider Name | Michael L Brian |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1790726842 PECOS PAC ID: 8123046562 Enrollment ID: I20051104000088 |
| Provider Name | Gary J Lavalley |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1285676205 PECOS PAC ID: 2062582661 Enrollment ID: I20080609000775 |
| Provider Name | Sarah Elizabeth Mulliniks |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1235566639 PECOS PAC ID: 5698902005 Enrollment ID: I20131210001612 |
| Provider Name | Nicholas J Hardgrave |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1285907139 PECOS PAC ID: 2769796333 Enrollment ID: I20150728003686 |
| Provider Name | Hayden Dean Black |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1184294464 PECOS PAC ID: 9638560360 Enrollment ID: I20220106001430 |
| Mailing Address | Practice Location Address |
|---|---|
| Henryetta Eye Center 900 W Main St, Henryetta, OK 74437-4252 Ph: (918) 652-2345 | Henryetta Eye Center 900 W Main St, Henryetta, OK 74437-4252 Ph: (918) 652-2345 |
Dr. Hayden Dean Black, OD Optometrist Medicare: May Accept Medicare Assignments Practice Location: 900 W Main St, Henryetta, OK 74437 Phone: 918-652-2345 | |
Mrs. Sarah Elizabeth Mulliniks, OD Optometrist Medicare: May Accept Medicare Assignments Practice Location: 900 W Main St, Henryetta, OK 74437 Phone: 918-652-2345 Fax: 918-652-2537 | |
Dr. Gary Jay Lavalley, O.D. Optometrist Medicare: May Accept Medicare Assignments Practice Location: 900 W Main St, Henryetta, OK 74437 Phone: 918-652-2345 Fax: 918-652-2537 | |
Lavalley Vision Care, Inc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 900 W Main St, Henryetta, OK 74437 Phone: 918-652-2345 Fax: 918-652-2537 | |
Gary Jay Lavalley, Pc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 900 W Main St, Henryetta, OK 74437 Phone: 918-652-2345 Fax: 918-652-2537 | |
Dr. Michael L Brian, OD Optometrist Medicare: Medicare Enrolled Practice Location: 900 W Main St, Henryetta, OK 74437 Phone: 918-652-2345 Fax: 918-652-2537 |