MR. JERRY K COBURN (OD) – Optometrist, NPI 1083681159

MR. JERRY K COBURN (OD) is a healthcare provider. based in Muskogee, Oklahoma. specializing in Optometrist. They hold the professional credentials OD. They hold a License No. 956 (OK). The NPI Number for MR. JERRY K COBURN (OD) is 1083681159

Main info

Male
47 Years Of Experience
Accepts Medicare Assignment
Name
MR. JERRY K COBURN (OD)
NPI
1083681159
Phone
(918) 682-7752
Address
742 N YORK ST
Enumeration Date
7 March 2006
Last Update Date
8 July 2010

Doctor Profile

Medical School Name
SOUTHERN COLLEGE OF OPTOMETRY
Secondary Phone
9186892677
Graduation Year
1979 (47 years ago)
PAC ID
2769371301
Group Practice PAC ID
6709077803
Professional Enrollment ID
I20101216000640
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for MR. JERRY K COBURN (OD)

  • Eye Care of Eastern Oklahoma, 742, North York Street, Reid Heights, Pierce Fuller, Muskogee, Muskogee County, Oklahoma, 74403, United States

    MUSKOGEE, OK 744033866

    Phone: (918) 682-7752

    Fax: (918) 687-8440

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 74403)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6709077803View full group profile
NameSpecialtyState
O P T O M E T R YOK
O P T O M E T R YOK

Reviews

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Frequently asked questions

What is the registry number for MR. JERRY K COBURN (OD)?
The registry entry for MR. JERRY K COBURN (OD) shows NPI 1083681159.
Is MR. JERRY K COBURN (OD) currently accepting referrals based on NPI status?
Registry metadata lists MR. JERRY K COBURN (OD) as active.
How should patients interpret MR. JERRY K COBURN (OD)'s specialty?
The extract shows Optometrist for MR. JERRY K COBURN (OD). Clinical services aligned with this taxonomy classification.
What geographic area is tied to MR. JERRY K COBURN (OD)?
MR. JERRY K COBURN (OD) is associated with Muskogee, Oklahoma in the same public data insurers reference.
Who maintains MR. JERRY K COBURN (OD)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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