MEDICARE: ARKANSAS OPHTHALMOLOGY CLINIC, 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	207W00000X	Ophthalmology Physician	C4653	AR
2	152W00000X	Optometrist	2248	AR

General Provider Information

NPI Number	:	1982667051
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARKANSAS OPHTHALMOLOGY CLINIC, P.A.

Provider Business Mailing Address
First Line	:	211 MCAULEY CT
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71913-6314
Country	:	US
Telephone Number	:	501-624-0609
Fax Number	:	501-624-6191

Provider Business Practice Location Address
First Line	:	211 MCAULEY CT
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71913-6314
Country	:	US
Telephone Number	:	501-624-0609
Fax Number	:	501-624-6191

Authorized Official
Title or Position	:	OWNER/OPHTHALMOLOGIST
Name	:	DR. TOM R WALLACE
Credential	:	M.D.
Telephone Number	:	501-624-0609

Provider Enumeration Date	:	04/10/2006
Last Update Date	:	09/11/2025

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1124021696 — DR. THOMAS R WALLACE M.D.
Practice Location Address:

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71913-6314

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1245231794 — JAMES A HUGHES MD
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1700887213 — JOSEPH W CENAC MD
Practice Location Address:

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1144213653 — DR. ROBERT WAYNE KLEINHENZ M. D.
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