Provider Demographics
NPI:1346727864
Name:MCCORD, NATALIE MARIE (OD)
Entity Type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:MARIE
Last Name:MCCORD
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 1:1455 S DOUGLAS BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73130-5269
Mailing Address - Country:US
Mailing Address - Phone:405-733-4545
Mailing Address - Fax:405-733-2758
Practice Address - Street 1:1455 S DOUGLAS BLVD STE D
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73130-5269
Practice Address - Country:US
Practice Address - Phone:405-733-4545
Practice Address - Fax:405-733-2758
Is Sole Proprietor?:No
Enumeration Date:2018-07-26
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2994152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist