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Contact Information

BROADWAY VISION ASSOCIATES, PLC
435 W BROADWAY ST
MUSKOGEE, OK74401-6614
 Phone: 918-687-4459
 Fax: 918-687-0238
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
 

Eyewear Supplier

332H00000X 87 All Other Suppliers
Indicates primary specialty

NPI Profile & details for BROADWAY VISION ASSOCIATES, PLC

NPI # 1154441848
LBN Legal business name BROADWAY VISION ASSOCIATES, PLC
Authorized official CANDACE STEWART - (OD OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 03/29/2007
Last updated 02/18/2010 - About 16 years ago
Identifiers
OK Medicaid 100739020A
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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