Provider Demographics
NPI:1720251408
Name:BURTON EYE CARE
Entity Type:Organization
Organization Name:BURTON EYE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:
Authorized Official - Last Name:BURTON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:501-565-1638
Mailing Address - Street 1:7308 BASELINE RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72209-4437
Mailing Address - Country:US
Mailing Address - Phone:501-565-1638
Mailing Address - Fax:501-565-8902
Practice Address - Street 1:7308 BASELINE RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72209-4437
Practice Address - Country:US
Practice Address - Phone:501-565-1638
Practice Address - Fax:501-565-8902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-02
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR2026152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR104319722Medicaid
AR104319722Medicaid
ART20249Medicare UPIN
AR48912Medicare PIN