Provider Demographics
NPI:1346237708
Name:HALL EYE CARE CENTER L.L.C.
Entity Type:Organization
Organization Name:HALL EYE CARE CENTER L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:479-705-2022
Mailing Address - Street 1:230 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72830-9069
Mailing Address - Country:US
Mailing Address - Phone:479-705-2022
Mailing Address - Fax:479-705-2023
Practice Address - Street 1:230 E MARKET ST
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:AR
Practice Address - Zip Code:72830-9069
Practice Address - Country:US
Practice Address - Phone:479-705-2022
Practice Address - Fax:479-705-2023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-30
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2537152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5F095Medicare ID - Type UnspecifiedCLINIC NUMBER