MEDICARE: SCHLUTERMAN EYE CARE & OPTICAL INC

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	2612	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376973164
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCHLUTERMAN EYE CARE & OPTICAL INC

Provider Business Mailing Address
First Line	:	9220 HIGHWAY 71 S
Second Line	:	SUITE 10
City	:	FORT SMITH
State	:	AR
Zip	:	72916-9117
Country	:	US
Telephone Number	:	479-646-2555
Fax Number	:	479-434-4140

Provider Business Practice Location Address
First Line	:	9220 HIGHWAY 71 S
Second Line	:	SUITE 10
City	:	FORT SMITH
State	:	AR
Zip	:	72916-9117
Country	:	US
Telephone Number	:	479-646-2555
Fax Number	:	479-434-4140

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ADAM SCHLUTERMAN
Credential	:	OD
Telephone Number	:	479-646-2555

Provider Enumeration Date	:	11/15/2013
Last Update Date	:	11/15/2013

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Directions to “SCHLUTERMAN EYE CARE & OPTICAL INC ” Practice Location

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