Clark Eye Clinic

LBN: Philip H. Clark, O.D., P.A.
Clark Eye Clinic is an health care organization with primary practice located at 302 N Phoenix Ave , Russellville AR 72801-2828. The organization recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as the primary health care specialty. Philip H. Clark, O.D., P.A. can be contacted via phone (479) 967-4711, or through Clark, Philip H via phone (479) 967-4711.

Contact Information

Primary practice address
302 N Phoenix Ave Russellville AR 72801-2828
Phone: (479) 967-4711
Fax: (479) 967-4485
Website:
Map and Directions
Authorized official contact:
Name: Clark, Philip H Doctor of Optometry (OD)
Phone: (479) 967-4711

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X AR2042 Arkansas

Profile Details

NPI number 1629370929
LBN Legal business name Philip H. Clark, O.D., P.A.
DBA Doing business as Clark Eye Clinic
Authorized official Clark, Philip H Doctor of Optometry (OD)
Entity Organization
Organization subpart 1 No
Enumeration date Nov 19th, 2010
Last updated Oct 26th, 2012 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629370929 NPPES
Arkansas MEDICAID 104322722

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