MEDICARE: KILGORE VISION CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1124170360	OTHER	AR	PTAN

General Provider Information

NPI Number	:	1124170360
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KILGORE VISION CENTER

Provider Business Mailing Address
First Line	:	PO BOX 444
Second Line	:
City	:	MOUNTAIN HOME
State	:	AR
Zip	:	72654-0444
Country	:	US
Telephone Number	:	870-424-4900
Fax Number	:

Provider Business Practice Location Address
First Line	:	105 SAWGRASS PT
Second Line	:
City	:	HARRISON
State	:	AR
Zip	:	72601-3072
Country	:	US
Telephone Number	:	870-741-1910
Fax Number	:

Authorized Official
Title or Position	:	PRACTICE ADMINISTRATOR
Name	:	MS. TINA CIKANEK
Credential	:
Telephone Number	:	870-741-1910

Provider Enumeration Date	:	01/17/2007
Last Update Date	:	01/07/2010

Similar Medicare Providers

1770586521 — DR. STEVEN T RAE OD
Practice Location Address:

105 SAWGRASS PT
HARRISON, AR
72601-3072

Practice Phone: 870-741-1910
Practice Fax: 870-741-6331

1780687525 — DR. ABRAHAM AKEL JR. OD
Practice Location Address:

105 SAWGRASS PT
HARRISON, AR
72601-3072

Practice Phone: 870-741-1910
Practice Fax: 870-741-6331

1063415891 — HARRISON SURGERY CENTER, LLC
Practice Location Address:

105 SAWGRASS PT
HARRISON, AR
72601-3072

Practice Phone: 870-741-9700
Practice Fax:

1275556334 — ALICE R LAULE M.D.
Practice Location Address:

105 SAWGRASS PT
HARRISON, AR
72601-3072

Practice Phone: 870-741-1910
Practice Fax: 870-741-6331

1811123458 — KRIS D ANDERSON MSW, LCSW
Practice Location Address:

117 SAWGRASS PT
HARRISON, AR
72601-3072

Practice Phone: 870-204-7488
Practice Fax: 870-204-5654

1134423585 — JUDY WHARFF MHPP
Practice Location Address:

121 SAW GRASSE POINT
HARRISON, AR
72601-3072

Practice Phone: 479-521-1427
Practice Fax: 479-521-6520

Directions to “KILGORE VISION CENTER ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.