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PEDIATRIC VISION DEVELOPMENT CENTER INC. NPI 1558427021


NPI Information

NPI: 1558427021
Provider Name: PEDIATRIC VISION DEVELOPMENT CENTER INC.
Classification: Optometrist - 152WV0400X
Entity Type: Organization

Specialization: Vision Therapy

Address:
101 DAWN DR
CENTERTON, AR
ZIP 72719
Phone: (479) 795-1411
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PEDIATRIC VISION DEVELOPMENT CENTER INC. is a vision therapy optometrist in Centerton, AR. The provider is optometrists who specialize in vision therapy as a treatment process used to improve vision function. It includes a broad range of developmental and rehabilitative treatment programs individually prescribed to remediate specific sensory, motor and/or visual perceptual dysfunctions. PEDIATRIC VISION DEVELOPMENT CENTER INC. NPI is 1558427021. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

101 DAWN DR
CENTERTON, AR
ZIP 72719-314
Phone: (479) 795-1411
Fax: (479) 795-1412

The provider's authorized official is Megan Petty .
The authorized official title is President and has the following contact phone number (479) 795-1411.

The enumeration date for this NPI number is 12/29/2006 and was last updated on 12/18/2013.


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
1152WV0400XOptometristVision Therapy2568ARKANSASYes

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
12568OTHERARKANSASSTATE LICENSE
249934MEDICARE ID-TYPE UNSPECIFIEDARKANSAS

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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