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NPI Code Detail

MEDICARE: KIMMY HOANG O.D.

MEDICARE:   KIMMY  HOANG  O.D.
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
1152W00000XOptometrist2683AR

General Provider Information

NPI Number : 1710321955
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMMY HOANG O.D.
Provider Business Mailing Address
First Line : 308 MONTICELLO WEST
Second Line :
City : BRYANT
State : AR
Zip : 72022
Country : US
Telephone Number : 870-723-5573
Fax Number :
Provider Business Practice Location Address
First Line : 3929 MCCAIN BLVD
Second Line :
City : NORTH LITTLE ROCK
State : AR
Zip : 72116
Country : US
Telephone Number : 501-412-8519
Fax Number : 501-712-1414
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2013
Last Update Date : 08/28/2014

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Directions to “ KIMMY HOANG O.D.” Practice Location

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