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General NPI Number Information
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NPI Number | 1063681039
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Entity Type | Organization
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Legal Business Name | DR. JAMES L. PRICE, JR.
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Dates
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Enumeration Date | 02/25/2008
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Last Update Date | 09/27/2013
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Provider Practice Location Address
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Address Line | 301 HIGHWAY 425 S
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City | MONTICELLO
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State | AR
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Zip | 71655-4611
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Country | US
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Telephone | 870-367-8534
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Fax | 870-367-0264
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Provider Business Mailing Address
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Address Line | 301 HIGHWAY 425 S
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City | MONTICELLO
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State | AR
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Zip | 71655-4611
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Country | US
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Telephone | 870-367-8534
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Fax | 870-367-0264
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAMES L PRICE JR.
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Credential | O.D.
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Telephone | 870-367-8534
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | AR2158
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | 2158
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License Number State | AR
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