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General NPI Number Information
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NPI Number | 1548438617
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Entity Type | Organization
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Legal Business Name | FAMILY EYECARE CLINIC INC
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Dates
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Enumeration Date | 02/12/2008
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Last Update Date | 12/05/2014
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Provider Practice Location Address
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Address Line | 8025 DOLLARWAY RD
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City | WHITE HALL
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State | AR
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Zip | 71602-2855
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Country | US
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Telephone | 870-247-2015
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Fax | 870-247-0238
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Provider Business Mailing Address
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Address Line | 8025 DOLLARWAY RD
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City | WHITE HALL
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State | AR
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Zip | 71602-2855
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Country | US
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Telephone | 870-247-2015
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Fax | 870-247-0238
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Authorized Official
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Title or Position | OPTOMETRIST/OWNER
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Name | RAYMOND F JONES
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Credential |
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Telephone | 870-247-2015
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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 | 2280
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License Number State | AR
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