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General NPI Number Information
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NPI Number | 1114052164
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Entity Type | Organization
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Legal Business Name | MERTINS FAMILY EYE CARE, INC.
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 03/18/2024
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Provider Practice Location Address
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Address Line | 640 N GARLAND AVE STE 110
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City | FAYETTEVILLE
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State | AR
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Zip | 72701-3072
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Country | US
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Telephone | 479-442-8400
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Fax | 800-807-8144
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Provider Business Mailing Address
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Address Line | 640 N GARLAND AVE STE 110
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City | FAYETTEVILLE
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State | AR
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Zip | 72701-3072
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Country | US
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Telephone | 479-442-8400
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Fax | 888-975-0944
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Authorized Official
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Title or Position | OWNER
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Name | DR. ALLYSON MERTINS
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Credential | O.D.
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Telephone | 479-442-8400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 2462
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2462
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License Number State | AR
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