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General NPI Number Information
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NPI Number | 1396897013
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Entity Type | Organization
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Legal Business Name | CHUNG EYE CARE, PA
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 04/25/2011
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Provider Practice Location Address
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Address Line | 25 E. WALNUT
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City | PARIS
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State | AR
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Zip | 72855
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Country | US
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Telephone | 479-963-2661
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Fax | 479-963-6821
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Provider Business Mailing Address
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Address Line | P.O. BOX 647
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City | PARIS
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State | AR
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Zip | 72855
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Country | US
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Telephone | 479-963-2661
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Fax | 479-963-6821
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Authorized Official
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Title or Position | CHAIRMAN
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Name | DR. KATHLEEN H CHUNG
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Credential | OD
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Telephone | 479-963-2661
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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 | 2579
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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 |
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License Number State |
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