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General NPI Number Information
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NPI Number | 1417479452
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Entity Type | Individual
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Provider Name | GEORGE C CORA OD
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Gender | Male
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Dates
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Enumeration Date | 07/12/2017
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Last Update Date | 02/25/2025
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Provider Practice Location Address
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Address Line | 1023 S MAIN ST
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City | MALVERN
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State | AR
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Zip | 72104-5222
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Country | US
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Telephone | 501-332-6262
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Fax | 501-337-0373
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Provider Business Mailing Address
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Address Line | 11225 HURON LN STE 200A
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City | LITTLE ROCK
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State | AR
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Zip | 72211-1861
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Country | US
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Telephone | 501-332-6262
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Fax | 501-337-0373
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 968
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License Number State | MS
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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 | R-359-TA-D49
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2779
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License Number State | AR
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