| |
301 Highway 425 S, Monticello, AR 71655-4611 | |
(870) 367-8534 | |
(870) 367-0264 |
Full Name | |
---|---|
Type | Facility |
Speciality | Eyewear Supplier |
Location | 301 Highway 425 S, Monticello, Arkansas |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1063681039 | NPI | - | NPPES |
102131722 | Medicaid | AR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | AR2158 (Arkansas) | Secondary |
332H00000X | Eyewear Supplier | 2158 (Arkansas) | Primary |
Mailing Address | Practice Location Address |
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301 Highway 425 S, Monticello, AR 71655-4611 Ph: (870) 367-8534 | 301 Highway 425 S, Monticello, AR 71655-4611 Ph: (870) 367-8534 |