Provider Demographics
NPI:1619318995
Name:BARTLESVILLE FAMILY EYECARE
Entity Type:Organization
Organization Name:BARTLESVILLE FAMILY EYECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LONA
Authorized Official - Middle Name:
Authorized Official - Last Name:LINDGREN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-335-1703
Mailing Address - Street 1:3903 E FRANK PHILLIPS BLVD
Mailing Address - Street 2:
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74006-8320
Mailing Address - Country:US
Mailing Address - Phone:918-333-2123
Mailing Address - Fax:918-333-8969
Practice Address - Street 1:3903 E FRANK PHILLIPS BLVD
Practice Address - Street 2:
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74006-8320
Practice Address - Country:US
Practice Address - Phone:918-333-2123
Practice Address - Fax:918-333-8969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-15
Last Update Date:2013-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1087152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty