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EAGLE MOUNTAIN EYE CARE NPI 1407119985


NPI Information

NPI: 1407119985
Provider Name: EAGLE MOUNTAIN EYE CARE
Classification: Optometrist - 152W00000X
Entity Type: Organization

CLIA Number: 04D2265956

Address:
3150 HARRISON ST
BATESVILLE, AR
ZIP 72501
Phone: (870) 793-6544
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EAGLE MOUNTAIN EYE CARE is an optometrist in Batesville, AR. The provider is doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. EAGLE MOUNTAIN EYE CARE NPI is 1407119985. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3150 HARRISON ST
BATESVILLE, AR
ZIP 72501-515
Phone: (870) 793-6544
Fax: (870) 793-7024

The provider's authorized official is Dustin Vance .
The authorized official title is President and has the following contact phone number (573) 382-2974.

The CLIA number assigned to this NPI record is 04D2265956 - school/student health service with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/20/2012 and was last updated on 6/20/2012.


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
1152W00000XOptometrist2657ARKANSASYes

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
15G795MEDICARE PINARKANSAS
2187164722MEDICAIDARKANSAS

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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