C Wallace Liles Iii O D Llc is a medicare enrolled "Optometrist" provider in De Queen, Arkansas. Their current practice location is
404d E Collin Raye Dr, De Queen, Arkansas. You can reach out to their office (for appointments etc.) via phone at
(870) 642-6900.
C Wallace Liles Iii O D Llc is licensed to practice in Arkansas (license number 2331) and it also participates in the medicare program. C Wallace Liles Iii O D Llc
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1376948687.
Healthcare Provider's Profile
Full Name | C Wallace Liles Iii O D Llc |
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Type | Facility |
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Speciality | Optometrist |
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Location | 404d E Collin Raye Dr, De Queen, Arkansas |
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Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1376948687
- Provider Enumeration Date: 10/29/2014
- Last Update Date: 10/29/2014
Medicare PECOS Information:
- PECOS PAC ID: 3476775396
- Enrollment ID: O20141110001028
Medical Identifiers
Medical identifiers for C Wallace Liles Iii O D Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1376948687 | NPI | - | NPPES |
181897722 | Medicaid | AR | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
152W00000X | Optometrist | 2331 (Arkansas) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
C Wallace Liles Iii O D Llc acts as a billing entity for following providers:
Provider Name | Clemit W Liles |
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Provider Type | Practitioner - Optometry |
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Provider Identifiers | NPI Number: 1003044355 PECOS PAC ID: 5597819748 Enrollment ID: I20090821000560 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. C Wallace Liles Iii O D Llc is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
C Wallace Liles Iii O D Llc 404d E Collin Raye Dr, De Queen, AR 71832-4149 Ph: (870) 642-6900 | C Wallace Liles Iii O D Llc 404d E Collin Raye Dr, De Queen, AR 71832-4149 Ph: (870) 642-6900 |
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