Provider Demographics
NPI:1578145769
Name:FLAIG, KRISTINA CARI (OD)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:CARI
Last Name:FLAIG
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:PO BOX 736
Mailing Address - Street 2:
Mailing Address - City:MARLOW
Mailing Address - State:OK
Mailing Address - Zip Code:73055-0736
Mailing Address - Country:US
Mailing Address - Phone:580-595-1609
Mailing Address - Fax:
Practice Address - Street 1:901 SW GOODYEAR BLVD
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-9755
Practice Address - Country:US
Practice Address - Phone:580-531-5790
Practice Address - Fax:580-353-2022
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-27
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2826152W00000X
OK3123152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist