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General NPI Number Information
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NPI Number | 1649449679
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Entity Type | Organization
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Legal Business Name | GARRY HAAS EYE CLINIC
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Dates
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Enumeration Date | 02/25/2008
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Last Update Date | 02/25/2008
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Provider Practice Location Address
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Address Line | 202 COUNTRY CLUB RD
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City | SHERWOOD
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State | AR
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Zip | 72120-4627
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Country | US
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Telephone | 501-835-7429
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Fax | 501-833-0028
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Provider Business Mailing Address
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Address Line | 202 COUNTRY CLUB RD
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City | SHERWOOD
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State | AR
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Zip | 72120-4627
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Country | US
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Telephone | 501-835-7429
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Fax | 501-833-0028
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Authorized Official
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Title or Position | MEDICAL BILLING MNGR
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Name | MS. APRIL MICHELE HOWARD
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Credential |
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Telephone | 501-835-7429
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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 | 2076
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License Number State | AR
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