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

Ethan David Wohlgemuth, OD

Individual provider Optometrist · NPI 1104506419

Ethan David Wohlgemuth, OD is an Optometrist in Tahlequah, Oklahoma. Licensed in Oklahoma. Registered with an NPI since 2023.

Licensed in
OK
In the registry since
2023
What do these letters mean?
OD — Doctor of Optometry
An optometrist: examines eyes, prescribes glasses and contacts, and treats many eye conditions.

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Practice location Address checks out

1001 N Grand Ave
Tahlequah, OK 74464-7017
Phone: (918) 444-4031
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence 3249 (OK)

Record details

NPI number1104506419
Entity typeIndividual (Type 1)
GenderMale
Credentials OD
Sole proprietorNo
NPI enumeratedJuly 20, 2023
Last updated in NPPESJuly 20, 2023
Certification dateJuly 20, 2023
Mailing address1001 N Grand Ave, Tahlequah, OK 74464-7017

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