NPI 1083681159

Jerry K Coburn, OD

Practitioner Optometrist Muskogee, OK

Practice location

Address: 742 N York St, Muskogee, OK 74403-3866
Phone: (918) 682-7752
Fax: (918) 687-8440

Registered specialties

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X Licence 956 (OK)

Other Optometrist providers in Oklahoma →

Registry record

NPI: 1083681159
Entity type: Individual
Sex (as registered): Male
NPI issued: 7 Mar 2006
Record last updated: 8 Jul 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.