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General NPI Number Information
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NPI Number | 1710958145
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Entity Type | Organization
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Legal Business Name | FLINTHILLS EYECARE ASSOCIATES PA
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Dates
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Enumeration Date | 02/01/2006
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Last Update Date | 12/17/2007
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Provider Practice Location Address
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Address Line | 512 COMMERCIAL ST
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City | EMPORIA
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State | KS
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Zip | 66801-4006
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Country | US
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Telephone | 620-343-7120
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Fax | 620-343-2038
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Provider Business Mailing Address
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Address Line | 512 COMMERCIAL ST
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City | EMPORIA
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State | KS
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Zip | 66801-4006
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Country | US
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Telephone | 620-343-7120
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Fax | 620-343-2038
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Authorized Official
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Title or Position | PRESIDENT
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Name | GILAN L COCKRELL
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Credential | OD
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Telephone | 620-343-7120
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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 |
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License Number State |
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