Provider Demographics
NPI:1740833227
Name:STIEB, KEVIN MILES (OD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:MILES
Last Name:STIEB
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:1415 W GORE BLVD
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73501-3606
Mailing Address - Country:US
Mailing Address - Phone:580-355-3036
Mailing Address - Fax:580-248-1162
Practice Address - Street 1:1415 W GORE BLVD
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73501-3606
Practice Address - Country:US
Practice Address - Phone:580-355-3036
Practice Address - Fax:580-248-1162
Is Sole Proprietor?:No
Enumeration Date:2019-07-23
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK3043152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist