Provider Demographics
NPI:1730621178
Name:CVI OKLAHOMA, P.C
Entity type:Organization
Organization Name:CVI OKLAHOMA, P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:BELARDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-755-7700
Mailing Address - Street 1:1555 PALM BEACH LAKES BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-2323
Mailing Address - Country:US
Mailing Address - Phone:561-965-9110
Mailing Address - Fax:561-684-7754
Practice Address - Street 1:11308 N PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-7752
Practice Address - Country:US
Practice Address - Phone:405-744-7700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-16
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty