Head, Robert Dale

Head, Robert Dale is an sole proprietor health care provider with primary practice located at 1302 Sw C Ave , Lawton OK 73501-4243. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Head, Robert Dale can be contacted via phone (580) 355-1298.

Contact Information

Primary practice address
1302 Sw C Ave Lawton OK 73501-4243
Phone: (580) 355-1298
Fax: (580) 581-7201
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 1049 Oklahoma

Profile Details

NPI number 1356470975
LBN Legal business name Head, Robert Dale
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 2nd, 2007
Last updated Mar 8th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356470975 NPPES
Oklahoma MEDICAID 100763770A

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