Provider Demographics
NPI:1487681920
Name:RINER, DARYLE JAY (OD)
Entity type:Individual
Prefix:DR
First Name:DARYLE
Middle Name:JAY
Last Name:RINER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:9720 E 31ST ST
Mailing Address - Street 2:#A-1
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74146-1206
Mailing Address - Country:US
Mailing Address - Phone:918-270-4410
Mailing Address - Fax:918-270-4583
Practice Address - Street 1:9720 E 31ST ST
Practice Address - Street 2:#A-1
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74146-1206
Practice Address - Country:US
Practice Address - Phone:918-270-4410
Practice Address - Fax:918-270-4583
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK2107152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKU43766Medicare UPIN