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General NPI Number Information
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NPI Number | 1285785071
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Entity Type | Organization
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Legal Business Name | JOE HORTON FAMILY EYE CARE, PA
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 02/25/2013
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Provider Practice Location Address
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Address Line | 3061 MARKET AVENUE SUITE 6
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City | FAYETTEVILLE
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State | AR
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Zip | 72703
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Country | US
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Telephone | 479-521-6460
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Fax | 479-442-3493
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Provider Business Mailing Address
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Address Line | 3061 MARKET AVENUE SUITE 6
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City | FAYETTEVILLE
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State | AR
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Zip | 72703
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Country | US
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Telephone | 479-521-6460
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Fax | 479-442-3493
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Authorized Official
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Title or Position | OPTOMETRIC PHYSICIAN
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Name | DR. JOE J HORTON
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Credential | OD
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Telephone | 479-521-6460
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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 | 2091
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License Number State | AR
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