Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Northeastern State University College of Optometry

Organization Optometrist · NPI 1437106333

Northeastern State University College of Optometry is an Optometrist in Tahlequah, Oklahoma. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
9

Practice location Address checks out

1001 N Grand Ave
Tahlequah, OK 74464-7017
Phone: (918) 458-2109
Fax: (918) 458-2310
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X
Corneal and Contact Management Optometrist Taxonomy 152WC0802X
Low Vision Rehabilitation Optometrist Taxonomy 152WL0500X
Pediatric Optometrist Taxonomy 152WP0200X
Sports Vision Optometrist Taxonomy 152WS0006X
Vision Therapy Optometrist Taxonomy 152WV0400X
Occupational Vision Optometrist Taxonomy 152WX0102X
Ophthalmology Physician Taxonomy 207W00000X
Eyewear Supplier Taxonomy 332H00000X

Record details

NPI number1437106333
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Douglas Penisten — Dean · (918) 456-5511
Other names Northeastern State University Oklahoma College Of Optometry
NPI enumeratedMay 27, 2006
Last updated in NPPESAugust 30, 2010
Mailing address1001 N Grand Ave, Tahlequah, OK 74464-7017

Other providers in Tahlequah