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OPHTHALMOLOGY ASSOCIATES OF BENTON PLLC NPI 1699774794


NPI Information

NPI: 1699774794
Provider Name: OPHTHALMOLOGY ASSOCIATES OF BENTON, PLLC
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
3 MEDICAL PARK DR
SUITE 300
BENTON, AR
ZIP 72015
Phone: (501) 778-1113
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OPHTHALMOLOGY ASSOCIATES OF BENTON, PLLC is a specialist in Benton, AR. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. OPHTHALMOLOGY ASSOCIATES OF BENTON, PLLC NPI is 1699774794. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

3 MEDICAL PARK DR
SUITE 300
BENTON, AR
ZIP 72015-728
Phone: (501) 778-1113
Fax: (501) 778-5391

The provider's authorized official is Linda Detherage .
The authorized official title is Insurance & Credentialing and has the following contact phone number (501) 778-1113.

The enumeration date for this NPI number is 7/20/2005 and was last updated on 9/30/2013.


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
1174400000XSpecialistE-2274ARKANSASNo
2174400000XSpecialistC7476ARKANSASNo
3174400000XSpecialistC7930ARKANSASYes

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
15B790OTHERARKANSASBLUE CROSS BLUE SHIELD
2140820002MEDICAIDARKANSAS
34167140001MEDICARE NSCARKANSAS
45B790MEDICARE PINARKANSAS
5CI3712OTHERARKANSASRAILROAD MEDICARE

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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