Provider Demographics
NPI:1689769481
Name:CURTIS, DENNIS E (OD)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:E
Last Name:CURTIS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 E JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:HUGO
Mailing Address - State:OK
Mailing Address - Zip Code:74743-4000
Mailing Address - Country:US
Mailing Address - Phone:580-326-3336
Mailing Address - Fax:
Practice Address - Street 1:506 E JACKSON ST
Practice Address - Street 2:
Practice Address - City:HUGO
Practice Address - State:OK
Practice Address - Zip Code:74743-4000
Practice Address - Country:US
Practice Address - Phone:580-326-3336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1194152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100761580AMedicaid
OK0645370001OtherDMERC PIN
OKOK00676701OtherBLUE CROSS BLUE SHIELD
OK1689769481OtherRAILROAD MEDICARE
OK$$$$$$$$$OtherMEDICARE PIN
OK$$$$$$$$$Medicare PIN
OK1689769481OtherRAILROAD MEDICARE