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NPI 1942418819

NPI 1942418819 : HYMAN VISION CLINIC : EARLE, AR

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General NPI Number Information
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    NPI Number           |    1942418819
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    Entity Type          |    Organization 
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    Legal Business Name  |    HYMAN VISION CLINIC 
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Dates
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    Enumeration Date     |    05/21/2007
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    Last Update Date     |    08/22/2020
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Provider Practice Location Address
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    Address Line         |    710 COMMERCE ST 
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    City                 |    EARLE
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    State                |    AR
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    Zip                  |    72331-1419
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    Country              |    US
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    Telephone            |    870-792-8444
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    710 COMMERCE ST 
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    City                 |    EARLE
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    State                |    AR
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    Zip                  |    72331-1419
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    Country              |    US
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    Telephone            |    870-792-8444
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |    DR. CHARLES FLOYD HYMAN 
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    Credential           |    O.D.
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    Telephone            |    870-792-8444
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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       |    2249
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    License Number State |    AR
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