Provider Demographics
NPI:1578651188
Name:DAVID MACARTY, OD PC
Entity Type:Organization
Organization Name:DAVID MACARTY, OD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:MACARTY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:580-832-3385
Mailing Address - Street 1:1200 N GLENN L ENGLISH ST
Mailing Address - Street 2:
Mailing Address - City:CORDELL
Mailing Address - State:OK
Mailing Address - Zip Code:73632-2015
Mailing Address - Country:US
Mailing Address - Phone:580-832-3385
Mailing Address - Fax:580-832-3990
Practice Address - Street 1:1200 N GLENN L ENGLISH ST
Practice Address - Street 2:
Practice Address - City:CORDELL
Practice Address - State:OK
Practice Address - Zip Code:73632-2015
Practice Address - Country:US
Practice Address - Phone:580-832-3385
Practice Address - Fax:580-832-3990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2045152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK446642625004OtherBLUE CROSS
OK100760170AMedicaid
OK1165930001Medicare NSC
OK446642625004OtherBLUE CROSS
OKU18452Medicare UPIN