Provider Demographics
NPI:1528394103
Name:CARL L. SYLVESTER, MD PC
Entity Type:Organization
Organization Name:CARL L. SYLVESTER, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:L
Authorized Official - Last Name:SYLVESTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-778-8993
Mailing Address - Street 1:13710 N PENNSYLVANIA AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73134-6030
Mailing Address - Country:US
Mailing Address - Phone:405-778-8993
Mailing Address - Fax:
Practice Address - Street 1:13710 N PENNSYLVANIA AVE STE 1
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73134-6030
Practice Address - Country:US
Practice Address - Phone:405-778-8993
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-02
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty