Provider Demographics
NPI:1952430480
Name:FLINT, KRISTINA LEIGH (OD)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:LEIGH
Last Name:FLINT
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1302 SW C AVE
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73501-4243
Mailing Address - Country:US
Mailing Address - Phone:580-355-1298
Mailing Address - Fax:580-581-7201
Practice Address - Street 1:1302 SW C AVE
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73501-4243
Practice Address - Country:US
Practice Address - Phone:580-355-1298
Practice Address - Fax:580-581-7201
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2450152W00000X, 152WL0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered152W00000XEye and Vision Services ProvidersOptometrist
Not Answered152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation