Provider Demographics
NPI:1699716266
Name:CASHMAN, ROBERT W (OD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:W
Last Name:CASHMAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 674
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:OK
Mailing Address - Zip Code:74821-0674
Mailing Address - Country:US
Mailing Address - Phone:580-436-2423
Mailing Address - Fax:580-436-2423
Practice Address - Street 1:718 ARLINGTON
Practice Address - Street 2:
Practice Address - City:ADA
Practice Address - State:OK
Practice Address - Zip Code:74820-3854
Practice Address - Country:US
Practice Address - Phone:580-436-2423
Practice Address - Fax:580-436-2423
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK997152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100761960AMedicaid
OK12034390OtherCAQH