| C Wallace Liles Jr Od Pa | |
|
404d E Collin Raye Dr, De Queen, AR 71832-4149 | |
| (870) 642-6900 | |
| (870) 642-4928 |
| Full Name | C Wallace Liles Jr Od Pa |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 404d E Collin Raye Dr, De Queen, Arkansas |
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316165178 | NPI | - | NPPES |
| 113655722 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | AR2331 (Arkansas) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| C Wallace Liles Jr Od Pa 404d E Collin Raye Dr, De Queen, AR 71832-4149 Ph: (870) 642-6900 | C Wallace Liles Jr Od Pa 404d E Collin Raye Dr, De Queen, AR 71832-4149 Ph: (870) 642-6900 |
C Wallace Liles Iii O D Llc Optometrist Medicare: Medicare Enrolled 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 | |
Med Southwest, Pllc 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 |