1902083280 NPI number — M. PATRICK DAY, OD, A PROFESSIONAL CORPORATION

Table of content: (NPI 1902083280)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902083280 NPI number — M. PATRICK DAY, OD, A PROFESSIONAL CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
M. PATRICK DAY, OD, A PROFESSIONAL CORPORATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CLINTON VISION SOURCE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1902083280
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/27/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 606
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLINTON
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73601-0606
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
580-323-5421
Provider Business Mailing Address Fax Number:
866-585-2957

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
565 S 30TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLINTON
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73601-3656
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
580-323-5421
Provider Business Practice Location Address Fax Number:
866-585-2957
Provider Enumeration Date:
01/29/2008

Additional Information

Authorized Official

Authorized Official Last Name:
DAY
Authorized Official First Name:
MARSHALL
Authorized Official Middle Name:
PATRICK
Authorized Official Title or Position:
CO-OWNER/OPTOMETRIST
Authorized Official Telephone Number:
580-323-5421

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  918 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 332H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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