| Dr Kenny J Wyatt, OD | |
|
202 Peabody, Mountain View, AR 72560 | |
| (870) 269-3610 | |
| (870) 269-5086 |
| Full Name | Dr Kenny J Wyatt |
|---|---|
| Gender | Male |
| Speciality | Optometrist - Corneal And Contact Management |
| Location | 202 Peabody, Mountain View, Arkansas |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427056951 | NPI | - | NPPES |
| 16064000040 | Other | AR | QUALCHOICE ID # |
| 106031722 | Medicaid | AR | |
| P00135331 | Other | AR | MEDICARE RR ID # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152WC0802X | Optometrist - Corneal And Contact Management | 2209 (Arkansas) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Kenny J Wyatt, OD Po Box 1460, Mountain View, AR 72560-1460 Ph: (870) 269-3610 | Dr Kenny J Wyatt, OD 202 Peabody, Mountain View, AR 72560 Ph: (870) 269-3610 |
Dr. Chris E Deitrick, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 101 Case Commons Dr., Mountain View, AR 72560 Phone: 870-269-3610 Fax: 870-269-5086 | |
Chris Deitrick Od Pa Optometrist Medicare: Medicare Enrolled Practice Location: 202 Peabody St, Mountain View, AR 72560 Phone: 870-269-3610 Fax: 870-269-5086 |