Provider Demographics
NPI:1437438629
Name:FORREST, SARAH GENE (OD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:GENE
Last Name:FORREST
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2000 S WHEELING AVE STE 500
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-5642
Mailing Address - Country:US
Mailing Address - Phone:918-747-3937
Mailing Address - Fax:918-748-8707
Practice Address - Street 1:7171 S YALE AVE STE 101
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-6367
Practice Address - Country:US
Practice Address - Phone:918-307-0496
Practice Address - Fax:918-461-1609
Is Sole Proprietor?:No
Enumeration Date:2011-08-05
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7861TG152W00000X
OK2694152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX285909201Medicaid
TX285909201Medicaid