Provider Demographics
NPI:1275116832
Name:BRIGHT EYES VISION CARE, PC
Entity Type:Organization
Organization Name:BRIGHT EYES VISION CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:DUFOUR
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:479-685-6875
Mailing Address - Street 1:900 S 52ND ST STE 102
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-8640
Mailing Address - Country:US
Mailing Address - Phone:479-657-6006
Mailing Address - Fax:479-657-6006
Practice Address - Street 1:900 S 52ND ST STE 102
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-8640
Practice Address - Country:US
Practice Address - Phone:479-657-6006
Practice Address - Fax:479-657-6006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-03
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No152WP0200XEye and Vision Services ProvidersOptometristPediatricsGroup - Multi-Specialty
No152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Multi-Specialty