Provider Demographics
NPI:1235123506
Name:EAKINS, SHERRI C (O D)
Entity Type:Individual
Prefix:
First Name:SHERRI
Middle Name:C
Last Name:EAKINS
Suffix:
Gender:F
Credentials:O D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4205 MCAULEY BLVD
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-8347
Mailing Address - Country:US
Mailing Address - Phone:405-755-6111
Mailing Address - Fax:405-755-6298
Practice Address - Street 1:4205 MCAULEY BLVD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-8347
Practice Address - Country:US
Practice Address - Phone:405-755-6111
Practice Address - Fax:405-755-6298
Is Sole Proprietor?:No
Enumeration Date:2005-09-01
Last Update Date:2009-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2271152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100760280AMedicaid
OK4093570002Medicare NSC
OKU45618Medicare UPIN
OK410044957Medicare PIN