Provider Demographics
NPI:1225163694
Name:COMPREHENSIVE EYE CARE, PC
Entity Type:Organization
Organization Name:COMPREHENSIVE EYE CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:918-341-7800
Mailing Address - Street 1:509 E BLUE STARR DR
Mailing Address - Street 2:
Mailing Address - City:CLAREMORE
Mailing Address - State:OK
Mailing Address - Zip Code:74017-4483
Mailing Address - Country:US
Mailing Address - Phone:918-341-7800
Mailing Address - Fax:918-341-7816
Practice Address - Street 1:509 E BLUE STARR DR
Practice Address - Street 2:
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74017-4483
Practice Address - Country:US
Practice Address - Phone:918-341-7800
Practice Address - Fax:918-341-7816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK19684207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100108220AMedicaid
OK180042533OtherPALMETTO GBA RAILROAD MEDICARE
OK443748386-005OtherBLUE CROSS BLUE SHIELD
OK2551753OtherAETNA
OKG28249Medicare UPIN
OK2551753OtherAETNA
OK100108220AMedicaid