| C Wallace Liles Iii O D Llc | |
|
404d E Collin Raye Dr, De Queen, AR 71832-4149 | |
| (870) 642-6900 | |
| (870) 642-4928 |
| Full Name | C Wallace Liles Iii O D Llc |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 404d E Collin Raye Dr, De Queen, Arkansas |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376948687 | NPI | - | NPPES |
| 181897722 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 2331 (Arkansas) | Primary |
| Provider Name | Clemit W Liles |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1003044355 PECOS PAC ID: 5597819748 Enrollment ID: I20090821000560 |
| 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 |
Liles Vision Clinic Optometrist Medicare: Not Enrolled in Medicare Practice Location: 404d E Collin Raye Dr, De Queen, AR 71832 Phone: 870-642-6900 Fax: 870-642-4928 | |
Bowman Family Eye Care Pllc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1302 W Collin Raye Dr, De Queen, AR 71832 Phone: 870-642-2677 Fax: 870-642-2777 | |
Myeyedr. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 404d E Collin Raye Dr, De Queen, AR 71832 Phone: 870-642-6900 Fax: 870-642-4928 |