Provider Demographics
NPI:1134504939
Name:HESS, BETHANY (OD)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:
Last Name:HESS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 S OAKWOOD RD STE C1
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73703-6277
Mailing Address - Country:US
Mailing Address - Phone:580-237-9379
Mailing Address - Fax:
Practice Address - Street 1:705 S OAKWOOD RD STE C1
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73703-6277
Practice Address - Country:US
Practice Address - Phone:580-237-9379
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-22
Last Update Date:2015-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2854152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist