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NPI Code Detail

MEDICARE: VISION GROUP ASC, LLC

MEDICARE: VISION GROUP ASC, LLC
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
1261QA1903XAmbulatory Surgical Clinic/CenterMC1632AR
2261QS0132XOphthalmologic Surgery Clinic/CenterAR4308AR

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00287824OTHERARRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4AR4308OTHERARLICENCE NUMBER

General Provider Information

NPI Number : 1902860679
Entity Type Code : Organization
Provider Name (Legal Business Name) : VISION GROUP ASC, LLC
Provider Business Mailing Address
First Line : 3002 ROGERS AVE
Second Line :
City : FORT SMITH
State : AR
Zip : 72901-4232
Country : US
Telephone Number : 479-782-8892
Fax Number : 479-782-8840
Provider Business Practice Location Address
First Line : 3002 ROGERS AVE
Second Line :
City : FORT SMITH
State : AR
Zip : 72901-4232
Country : US
Telephone Number : 479-782-8892
Fax Number : 479-782-8840
Authorized Official
Title or Position : CHIEF OF STAFF
Name : DR. CLAIRE B. PRICE
Credential : MD
Telephone Number : 479-782-8892
Provider Enumeration Date : 04/12/2006
Last Update Date : 02/23/2010

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Directions to “VISION GROUP ASC, LLC ” Practice Location

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