Northeastern State University College Of Optometry
Optometrist Clinic
1001 N Grand Ave, Tahlequah
Oklahoma, 74464-7017
918-458-2109 918-458-2310
Maps & DirectionsNortheastern State University College Of Optometry is a Corneal and Contact Management Optometrist Center in Tahlequah, Oklahoma. It is situated at 1001 N Grand Ave, Tahlequah and its contact number is 918-458-2109. The authorized person of Northeastern State University College Of Optometry is Dr. Douglas Penisten
who is Dean of the clinic and their contact number is 918-456-5511.
Northeastern State University College Of Optometry Center have optometrists who can perform professional activities related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea's ability to sustain successful contact lens wear, and treatment of any external eye or corneal condition which can affect contact lens wear.
Complete Profile:
Northeastern State University College Of Optometry Center speciality, address, contact phone number and fax are as below.
Patients can call the eye care center on the below given phone number for appointment.
| Specialization: | Optometry - Corneal and Contact Management |
| Address: | 1001 N Grand Ave, Tahlequah,
Oklahoma, 74464-7017 |
| Phone: | 918-458-2109 |
| Fax: | 918-458-2310 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this clinic are as below. Person's position and contact details are also mentioned below.
| Name: | Dr. Douglas Penisten |
| Position: | Dean |
| Contact Number: | 918-456-5511 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Northeastern State University College Of Optometry Center are as mentioned below.
| NPI Number: | 1437106333 |
| NPI Enumeration Date: | 27 May, 2006 |
| NPI Last Update On: | 30 Aug, 2010 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Northeastern State University College Of Optometry are as mentioned below.
| Specialization | License Number | State | Status | |
| Optometrist | | | Primary | |
| Optometry - Corneal and Contact Management | | | Secondary | |
| Optometry - Low Vision Rehabilitation | | | Secondary | |
| Optometry - Pediatrics | | | Secondary | |
| Optometry - Vision Therapy | | | Secondary | |
| Optometry - Occupational Vision | | | Secondary | |
| Optometry - Sports Vision | | | Secondary | |
| Ophthalmology | | | Secondary | |
| Eyewear Supplier (equipment, Not The Service) | | | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 100732440A | Medicaid | Oklahoma | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Northeastern State University College Of Optometry
1001 N Grand Ave,
Tahlequah, Oklahoma |
| Zip: | 74464-7017 |
| Phone Number: | 918-458-2109 |
| Fax Number: | 918-458-2310 |
Patients can reach Northeastern State University College Of Optometry at
1001 N Grand Ave, Tahlequah, Oklahoma or can
call to book an appointment on 918-458-2109.
Comments/ Reviews:
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** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 June, 2026.