Provider Demographics
NPI:1922440270
Name:REBECCA M. KING, O.D., P.A.
Entity Type:Organization
Organization Name:REBECCA M. KING, O.D., P.A.
Other - Org Name:CLARKSVILLE FAMILY EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:M
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:479-264-5588
Mailing Address - Street 1:210 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72830-3010
Mailing Address - Country:US
Mailing Address - Phone:479-754-3309
Mailing Address - Fax:
Practice Address - Street 1:210 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:AR
Practice Address - Zip Code:72830-3010
Practice Address - Country:US
Practice Address - Phone:479-754-3309
Practice Address - Fax:479-754-3955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-26
Last Update Date:2013-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty