Provider Demographics
NPI:1265492581
Name:CENTRAL OKLAHOMA EYE ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:CENTRAL OKLAHOMA EYE ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:D
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-949-6401
Mailing Address - Street 1:5701 N PORTLAND AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-1670
Mailing Address - Country:US
Mailing Address - Phone:405-949-6401
Mailing Address - Fax:405-949-4283
Practice Address - Street 1:5701 N PORTLAND AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-1670
Practice Address - Country:US
Practice Address - Phone:405-949-6401
Practice Address - Fax:405-949-4283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-23
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK18051207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty