Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207W00000X | Ophthalmologist | 3145 | OK |
NPI | 1013910090 |
---|---|
Provider Name | Anthony Economou |
First Address | Tulsa, OK 74105-6233 |
Second Address | Tulsa, OK 74105-6233 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2005 |
Last Update Date | 10/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100137560A | (05) | OK |
1101708 | FIRST HEALTH (01) | OK |
1732450 | UNITED HEALTHCARE (01) | OK |
5533545 | AETNA (01) | OK |
G35783 | (02) | OK |