Provider Demographics
NPI:1871613547
Name:ANTHONY ECONOMOU DO PC
Entity type:Organization
Organization Name:ANTHONY ECONOMOU DO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:ECONOMOU
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:918-317-0022
Mailing Address - Street 1:2865 E SKELLY DR STE 250
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74105-6233
Mailing Address - Country:US
Mailing Address - Phone:918-317-0022
Mailing Address - Fax:855-327-9828
Practice Address - Street 1:2865 E SKELLY DR STE 250
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74105-6233
Practice Address - Country:US
Practice Address - Phone:918-317-0022
Practice Address - Fax:855-327-9828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0009XAllopathic & Osteopathic PhysiciansOphthalmologyGlaucoma SpecialistGroup - Single Specialty
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty