Organization Name: | OPHTHALMOLOGY ASSOCIATES OF BENTON, PLLC |
NPI Number: | 1699774794 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LINDA DETHERAGE (INSURANCE & CREDENTIALING) |
Mailing Address: | 3 Medical Park Dr Suite 300 Benton |
State: | AR US |
Postal Code: | 720153728 |
Phone Number: | 5017781113 |
Fax Number: | 5017785391 |
NPI Enumeration Date: | 07/20/2005 |
NPI Last Update Date: | 09/30/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | E-2274 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | AR |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | 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. |