| Kedzymac Enterprises, Llc | |
|
107 S Broadway St, Cleveland, OK 74020-4614 | |
| (918) 385-2245 | |
| Not Available |
| Full Name | Kedzymac Enterprises, Llc |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 107 S Broadway St, Cleveland, Oklahoma |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376272369 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (* (Not Available)) | Primary |
| Provider Name | Lisa M Kedzuf-mcginnis |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1134216609 PECOS PAC ID: 1951318872 Enrollment ID: I20060329000012 |
| Mailing Address | Practice Location Address |
|---|---|
| Kedzymac Enterprises, Llc 9318 Scarlet Oak Dr, Sand Springs, OK 74063-3901 Ph: () - | Kedzymac Enterprises, Llc 107 S Broadway St, Cleveland, OK 74020-4614 Ph: (918) 385-2245 |
Dr. Lisa Marie Kedzuf-mcginnis, O.D. Optometrist Medicare: Medicare Enrolled Practice Location: 107 S Broadway St, Cleveland, OK 74020 Phone: 918-358-2245 | |
Dr. Gregory A. Fielding , P.c. Optometrist Medicare: Medicare Enrolled 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 |