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WEST MEMPHIS EYE CENTER PA NPI 1205860459


NPI Information

NPI: 1205860459
Provider Name: WEST MEMPHIS EYE CENTER, PA

Doing Business As: GLEN EDWARD BRYANT JR.

Classification: Ophthalmology - 207W00000X
Entity Type: Organization

CLIA Number: 04D0467684

Address:
303 W POLK
SUITE A
WEST MEMPHIS, AR
ZIP 72301
Phone: (870) 732-2100
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WEST MEMPHIS EYE CENTER, PA is an ophthalmology in West Memphis, AR. The provider is an ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. WEST MEMPHIS EYE CENTER, PA NPI is 1205860459. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Glen Edward Bryant Jr..

The provider's business location address is:

303 W POLK
SUITE A
WEST MEMPHIS, AR
ZIP 72301
Phone: (870) 732-2100
Fax: (870) 732-3027

The provider's authorized official is Glen Edward Bryant .
The authorized official title is Owner and has the following contact phone number (870) 732-2100.

The CLIA number assigned to this NPI record is 04D0467684 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/11/2006 and was last updated on 12/12/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207W00000XOphthalmologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1102003001MEDICAIDARKANSAS
257162MEDICARE ID-TYPE UNSPECIFIED
3111786002MEDICAIDARKANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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