Provider Demographics
NPI:1477869618
Name:HON Q CHUNG EYECARE PA
Entity Type:Organization
Organization Name:HON Q CHUNG EYECARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HON
Authorized Official - Middle Name:Q
Authorized Official - Last Name:CHUNG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:479-452-9173
Mailing Address - Street 1:7320 ROGERS AVE
Mailing Address - Street 2:SUITE 14
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72903-4166
Mailing Address - Country:US
Mailing Address - Phone:479-452-9173
Mailing Address - Fax:
Practice Address - Street 1:7320 ROGERS AVE
Practice Address - Street 2:SUITE 14
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-4166
Practice Address - Country:US
Practice Address - Phone:479-452-9173
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-25
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2645152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty