Provider Demographics
NPI:1811689961
Name:20-20 EYECARE OF BATESVILLE LLC
Entity type:Organization
Organization Name:20-20 EYECARE OF BATESVILLE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:WALLS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:662-226-7010
Mailing Address - Street 1:150 CRACKER BARRELL DR
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38606-3031
Mailing Address - Country:US
Mailing Address - Phone:662-270-8090
Mailing Address - Fax:662-480-8660
Practice Address - Street 1:150 CRACKER BARRELL DR
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:MS
Practice Address - Zip Code:38606-3031
Practice Address - Country:US
Practice Address - Phone:662-270-8090
Practice Address - Fax:662-480-8660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-25
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty