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General NPI Number Information
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NPI Number | 1104096767
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Entity Type | Organization
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Legal Business Name | LARRY E. MCCALL, O.D., INC.
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Dates
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Enumeration Date | 03/10/2008
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Last Update Date | 06/10/2011
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Provider Practice Location Address
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Address Line | 506 W ARCH AVE
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City | SEARCY
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State | AR
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Zip | 72143-5204
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Country | US
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Telephone | 501-268-3149
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Fax |
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Provider Business Mailing Address
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Address Line | 506 W ARCH AVE
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City | SEARCY
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State | AR
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Zip | 72143-5204
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Country | US
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Telephone | 501-268-3149
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Fax | 501-268-9583
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | LARRY E MCCALL
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Credential |
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Telephone | 501-268-3149
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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 | 2119
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License Number State | AR
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