Healthcare Provider Details

I. General information

NPI: 1467533554
Provider Name (Legal Business Name): MASSEY EYE CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 03/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1244 HIGHWAY 62 412
HIGHLAND AR
72542-9468
US

IV. Provider business mailing address

1244 HIGHWAY 62 412
HIGHLAND AR
72542-9468
US

V. Phone/Fax

Practice location:
  • Phone: 870-994-2737
  • Fax: 870-994-7111
Mailing address:
  • Phone: 870-994-2737
  • Fax: 870-994-7111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMES YOUNG MASSEY
Title or Position: OWNER
Credential: M.D.
Phone: 870-994-2737