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NPI Code Detail

MEDICARE: CRESTVIEW OPTICAL

MEDICARE: CRESTVIEW OPTICAL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1156FX1800XOpticianOP1100385AR

General Provider Information

NPI Number : 1669565255
Entity Type Code : Organization
Provider Name (Legal Business Name) : CRESTVIEW OPTICAL
Provider Business Mailing Address
First Line : 521 MARSHALL RD
Second Line :
City : JACKSONVILLE
State : AR
Zip : 72076-3749
Country : US
Telephone Number : 501-985-0616
Fax Number : 501-985-0715
Provider Business Practice Location Address
First Line : 521 MARSHALL RD
Second Line :
City : JACKSONVILLE
State : AR
Zip : 72076-3749
Country : US
Telephone Number : 501-985-0616
Fax Number :
Authorized Official
Title or Position : PRACTICE MANAGER
Name : PAM ABLES
Credential :
Telephone Number : 501-985-0616
Provider Enumeration Date : 10/02/2006
Last Update Date : 05/19/2026

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Directions to “CRESTVIEW OPTICAL ” Practice Location

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