Provider Demographics
NPI:1578991758
Name:TECUMSEH EYE ASSOCIATES PLLC
Entity Type:Organization
Organization Name:TECUMSEH EYE ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OD
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:K
Authorized Official - Last Name:KARNISH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:405-598-6558
Mailing Address - Street 1:123 E WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:TECUMSEH
Mailing Address - State:OK
Mailing Address - Zip Code:74873-3241
Mailing Address - Country:US
Mailing Address - Phone:405-598-6558
Mailing Address - Fax:405-598-2202
Practice Address - Street 1:123 E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:TECUMSEH
Practice Address - State:OK
Practice Address - Zip Code:74873-3241
Practice Address - Country:US
Practice Address - Phone:405-598-6558
Practice Address - Fax:405-598-2202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-24
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty