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NPI Code Detail

MEDICARE: FAMILY VISION CLINIC

MEDICARE: FAMILY VISION CLINIC
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
1152W00000XOptometrist

General Provider Information

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

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Directions to “FAMILY VISION CLINIC ” Practice Location

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