Healthcare Provider Details

I. General information

NPI: 1407818776
Provider Name (Legal Business Name): EYE CARE SPECIALTIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2006
Last Update Date: 01/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 PLAZA CARMONA PL SUITE C
HOT SPRINGS VILLAGE AR
71909-3000
US

IV. Provider business mailing address

101 PLAZA CARMONA PL SUITE C
HOT SPRINGS VILLAGE AR
71909-3000
US

V. Phone/Fax

Practice location:
  • Phone: 501-922-5778
  • Fax: 501-922-6659
Mailing address:
  • Phone: 501-922-5778
  • Fax: 501-922-6659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberAR 2436
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberAR 2435
License Number StateAR

VIII. Authorized Official

Name: DR. SUSAN SEMMLER
Title or Position: OPTOMETRIST/ VICE-PRESIDENT
Credential: O.D.
Phone: 501-922-5778