GARY A DORMAN NPI 1023295839

Eyewear Supplier in Ponca City, OK

NPI 1023295839 Organization Eyewear Supplier

About GARY A DORMAN

Gary A Dorman is a provider established in Ponca City, Oklahoma specializing in eyewear supplier. The NPI number of Gary A Dorman is 1023295839 and was assigned on January 2008. The practitioner's primary taxonomy code is 332H00000X with license number 1043 (OK). The provider is registered as an organization and their NPI record was last updated 7 years ago. The authorized official of this NPI record is Dr. Gary Dorman (Owner)

NPI

1023295839

Provider NameGARY A DORMAN
Provider Location Address400 FAIRVIEW SUITE 21 PONCA CITY, OK 74601
Provider Mailing Address400 FAIRVIEW SUITE 21 PONCA CITY, OK 74601
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date01-23-2008
Last Update Date11-04-2014


Primary Taxonomy

Taxonomy Code332H00000X
ClassificationEyewear Supplier
TypeSuppliers
License No.1043
License StateOK
Taxonomy DescriptionAn organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.

Business Address

GARY A DORMAN
400 FAIRVIEW
SUITE 21
PONCA CITY, OK
ZIP 74601
Phone: (580) 765-3356
Fax: (580) 765-3353

Get Directions


Mailing Address

GARY A DORMAN
400 FAIRVIEW
SUITE 21
PONCA CITY, OK
ZIP 74601
Phone: (580) 765-3356
Fax: (580) 765-3353



Authorized Official

Authorized Official NameDR. GARY DORMAN
Authorized Official TitleOWNER
Authorized Official Phone(580) 765-3356

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
0982390001MEDICARE NSC (07)OK

Other Providers at the same location


The following 4 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1295790459MR. SHRIKRISHNA V VAIDYA MD
Individual
Psychiatry & Neurology (Neurology)400 FAIRVIEW ST 10
PONCA CITY, OK 74601
(580) 762-7734
1356399927MRS. ALZIRA F VAIDYA MD
Individual
Psychiatry & Neurology (Child & Adolescent Psychiatry)400 FAIRVIEW ST 10
PONCA CITY, OK 74601
(580) 762-7701
1265531610MR. PHILLIP JOSEPH KNIGHT MD
Individual
Family Medicine400 FAIRVIEW SUITE 15
PONCA CITY, OK 74601
(580) 765-2498
1780960468PONCA SLEEP INTERPRETORS LLC
Organization
Specialist400 FAIRVIEW SUITE10
PONCA CITY, OK 74601
(580) 762-7734

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.