Provider Demographics
NPI:1902804172
Name:CARLIN, CATHERINE F (OD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:F
Last Name:CARLIN
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 1:6303 NW 23RD ST
Mailing Address - Street 2:
Mailing Address - City:BETHANY
Mailing Address - State:OK
Mailing Address - Zip Code:73008-5931
Mailing Address - Country:US
Mailing Address - Phone:405-782-0300
Mailing Address - Fax:405-782-0302
Practice Address - Street 1:6303 NW 23RD ST
Practice Address - Street 2:
Practice Address - City:BETHANY
Practice Address - State:OK
Practice Address - Zip Code:73008-5931
Practice Address - Country:US
Practice Address - Phone:405-782-0300
Practice Address - Fax:405-782-0302
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2013-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2093152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100762240AMedicaid
OK245621501OtherAFFORDABLE PRICE VISION CTR., INC. MEDICARE
OK268743YNPTMedicare PIN
OK100762240AMedicaid
OK3941160001Medicare NSC