| |
204 E 2nd Sreet S, Prescott, AR 71857 | |
(870) 887-3596 | |
(870) 887-3945 |
Full Name | |
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Type | Facility |
Speciality | Optometrist |
Location | 204 E 2nd Sreet S, Prescott, Arkansas |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1699856278 | NPI | - | NPPES |
410011556 | Other | AR | RAILROAD MEDICARE |
112122722 | Medicaid | AR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 2325 (Arkansas) | Primary |
Provider Name | Audie M Teague |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1821185091 PECOS PAC ID: 9931115979 Enrollment ID: I20060301000095 |
Provider Name | Kristen Teague |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1598079451 PECOS PAC ID: 3678697372 Enrollment ID: I20100902000086 |
Mailing Address | Practice Location Address |
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Po Box 189, Prescott, AR 71857-0189 Ph: (870) 887-3596 | 204 E 2nd Sreet S, Prescott, AR 71857 Ph: (870) 887-3596 |
Dr. Audie M. Teague, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 204 E 2nd Street S, Prescott, AR 71857 Phone: 870-887-3596 Fax: 870-887-3945 |