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General NPI Number Information
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NPI Number | 1609990357
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Entity Type | Organization
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Legal Business Name | MCDONALD EYE SERVICES, PA
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 10/18/2007
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Provider Practice Location Address
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Address Line | 3318 N NORTHHILLS BLVD
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-4008
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Country | US
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Telephone | 479-521-2555
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Fax | 479-521-6761
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Provider Business Mailing Address
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Address Line | 3318 N NORTHHILLS BLVD
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-4008
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Country | US
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Telephone | 479-521-2555
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Fax | 479-521-6761
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. VONDA LOUISE SYLER
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Credential | COE
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Telephone | 479-521-2555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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