Provider Demographics
NPI:1508801721
Name:ADAMS EYE CARE CLINIC, P.A.
Entity Type:Organization
Organization Name:ADAMS EYE CARE CLINIC, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:LARRY
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:501-354-1610
Mailing Address - Street 1:103 N SAINT JOSEPH ST
Mailing Address - Street 2:PO BOX 107
Mailing Address - City:MORRILTON
Mailing Address - State:AR
Mailing Address - Zip Code:72110-2915
Mailing Address - Country:US
Mailing Address - Phone:501-354-1610
Mailing Address - Fax:501-354-1013
Practice Address - Street 1:103 N SAINT JOSEPH ST
Practice Address - Street 2:
Practice Address - City:MORRILTON
Practice Address - State:AR
Practice Address - Zip Code:72110-2915
Practice Address - Country:US
Practice Address - Phone:501-354-1610
Practice Address - Fax:501-354-1013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-19
Last Update Date:2008-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPC099152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR141445722Medicaid
AR141445722Medicaid
AR4002410001Medicare NSC