Provider Demographics
NPI:1760565410
Name:BILLY G SLOAT PC
Entity Type:Organization
Organization Name:BILLY G SLOAT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BILLY
Authorized Official - Middle Name:G
Authorized Official - Last Name:SLOAT
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:580-237-9379
Mailing Address - Street 1:705 S OAKWOOD RD
Mailing Address - Street 2:SUITE C-1
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73703-6277
Mailing Address - Country:US
Mailing Address - Phone:580-237-9379
Mailing Address - Fax:580-237-9380
Practice Address - Street 1:705 S OAKWOOD RD
Practice Address - Street 2:SUITE C-1
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73703-6277
Practice Address - Country:US
Practice Address - Phone:580-237-9379
Practice Address - Fax:580-237-9380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1034152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK5613410001Medicare NSC