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General NPI Number Information
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NPI Number | 1396813945
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Entity Type | Organization
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Legal Business Name | DEER EYE CLINIC PA
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 07/17/2019
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Provider Practice Location Address
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Address Line | 4942 W. MARKHAM
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City | LITTLE ROCK
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State | AR
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Zip | 72205
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Country | US
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Telephone | 501-224-4701
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Fax | 501-224-1003
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Provider Business Mailing Address
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Address Line | 4942 W. MARKHAM
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City | LITTLE ROCK
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State | AR
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Zip | 72205
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Country | US
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Telephone | 501-224-4701
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Fax | 501-224-1003
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. PHILIP JAMES DEER III
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Credential | M.D.
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Telephone | 501-224-4701
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | R-1735
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License Number State | AR
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