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General NPI Number Information
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NPI Number | 1902112667
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Entity Type | Organization
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Legal Business Name | FAMILY VISION CLINIC
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Dates
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Enumeration Date | 08/19/2010
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Last Update Date | 08/19/2010
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Provider Practice Location Address
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Address Line | 8801 BASELINE RD
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City | LITTLE ROCK
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State | AR
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Zip | 72209-5901
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Country | US
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Telephone | 501-565-2848
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Fax | 501-565-2724
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Provider Business Mailing Address
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Address Line | 8801 BASELINE ROAD
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City | LITTLE ROCK
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State | AR
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Zip | 72209
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Country | US
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Telephone | 501-565-2848
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Fax | 501-565-2724
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Authorized Official
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Title or Position | OPTOMETRIST/OWNER
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Name | DR. EDWIN BROWN DUNAWAY
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Credential | O.D.
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Telephone | 501-565-2848
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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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