Provider Demographics
NPI:1912211350
Name:BURKHART, SAUNYA M (OD)
Entity Type:Individual
Prefix:DR
First Name:SAUNYA
Middle Name:M
Last Name:BURKHART
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:SAUNYA
Other - Middle Name:
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:32205 S 4531 RD
Mailing Address - Street 2:
Mailing Address - City:AFTON
Mailing Address - State:OK
Mailing Address - Zip Code:74331-5546
Mailing Address - Country:US
Mailing Address - Phone:918-639-7692
Mailing Address - Fax:
Practice Address - Street 1:1013 S MAIN ST
Practice Address - Street 2:
Practice Address - City:GROVE
Practice Address - State:OK
Practice Address - Zip Code:74344-2847
Practice Address - Country:US
Practice Address - Phone:918-786-9777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-27
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2669152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200301810AMedicaid