Provider Demographics
NPI:1801345426
Name:THE EXCLUSIVE EYE, PLLC
Entity type:Organization
Organization Name:THE EXCLUSIVE EYE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:L
Authorized Official - Last Name:DINWIDDIE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:479-305-1571
Mailing Address - Street 1:1810 N COLLEGE AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-2607
Mailing Address - Country:US
Mailing Address - Phone:479-903-7393
Mailing Address - Fax:479-802-6204
Practice Address - Street 1:1810 N COLLEGE AVE STE 110
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-2607
Practice Address - Country:US
Practice Address - Phone:479-903-7393
Practice Address - Fax:479-802-6204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-23
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2662152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty