Provider Demographics
NPI:1871251769
Name:ADVANCED LASER AND CATARACT CENTER LLC
Entity Type:Organization
Organization Name:ADVANCED LASER AND CATARACT CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:BELARDO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-755-7700
Mailing Address - Street 1:11308 N PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-7752
Mailing Address - Country:US
Mailing Address - Phone:405-755-7700
Mailing Address - Fax:405-751-1469
Practice Address - Street 1:11308 N PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-7752
Practice Address - Country:US
Practice Address - Phone:405-755-7700
Practice Address - Fax:405-751-1469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-07
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
No261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic Surgery