MEDICARE: DANG EYECARE & ASSOCIATES, P.A.

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
1	152W00000X	Optometrist

General Provider Information

NPI Number	:	1801038195
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DANG EYECARE & ASSOCIATES, P.A.

Provider Business Mailing Address
First Line	:	4189 PHOENIX AVE STE B
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72903-6013
Country	:	US
Telephone Number	:	479-452-6120
Fax Number	:

Provider Business Practice Location Address
First Line	:	4189 PHOENIX AVE
Second Line	:	B
City	:	FORT SMITH
State	:	AR
Zip	:	72903-6013
Country	:	US
Telephone Number	:	479-452-8146
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. KEVIN DANG
Credential	:	O.D.
Telephone Number	:	479-452-6120

Provider Enumeration Date	:	04/01/2009
Last Update Date	:	09/29/2020

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