Provider Demographics
NPI:1609903210
Name:FIRST LOOK EYEWEAR
Entity Type:Organization
Organization Name:FIRST LOOK EYEWEAR
Other - Org Name:JAY E LEEMASTER, MD
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:E
Authorized Official - Last Name:LEEMASTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-793-1181
Mailing Address - Street 1:2909 S TELEPHONE RD
Mailing Address - Street 2:
Mailing Address - City:MOORE
Mailing Address - State:OK
Mailing Address - Zip Code:73160-2937
Mailing Address - Country:US
Mailing Address - Phone:405-793-1181
Mailing Address - Fax:405-790-0705
Practice Address - Street 1:2909 S TELEPHONE RD
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:OK
Practice Address - Zip Code:73160-2937
Practice Address - Country:US
Practice Address - Phone:405-793-1181
Practice Address - Fax:405-790-0705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK232301332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK791587971OtherWATERSTONE
OK100769110AMedicaid
OK446523420-001OtherBLUE CROSS BLUE SHIELD
OK=========OtherLETTER CARRIERS
OK=========OtherCONTINENTAL LIFE
OK=========OtherTRICARE
OK=========OtherVISION CARE, INC.
OK=========OtherGEHA
OK=========OtherUNITED AMERICAN INSURANCE
OK=========OtherPHYSICIANS MUTUAL
OK=========OtherHARTFORD SENIOR MEDICAL
OK100769110AMedicaid
OK=========OtherUNITED HEALTH CARE
OK=========OtherFIRST HEALTH
OK791587971OtherWATERSTONE
OK=========OtherHEALTH CHOICE
OK446523420-001OtherBLUE CROSS BLUE SHIELD
OH=========OtherMUTUAL ASSURANCE ADMINIST
OK=========OtherSTERLING LIFE INSURANCE
OK=========OtherC L FRATES