Provider Demographics
NPI:1699781849
Name:STROTHER, DAVID L (OD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:L
Last Name:STROTHER
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 1:3852 N MACARTHUR BLVD
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73122-2016
Mailing Address - Country:US
Mailing Address - Phone:405-789-1542
Mailing Address - Fax:405-789-3145
Practice Address - Street 1:3852 N MACARTHUR BLVD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73122-2016
Practice Address - Country:US
Practice Address - Phone:405-789-1542
Practice Address - Fax:405-789-3145
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK849152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK5720242OtherAETNA
OK5720242OtherAETNA
OK0844870001Medicare NSC