Provider Demographics
NPI:1528235090
Name:MENA EYE CARE
Entity type:Organization
Organization Name:MENA EYE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BILL
Authorized Official - Middle Name:J
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:479-394-4083
Mailing Address - Street 1:600 HIGHWAY 71 N
Mailing Address - Street 2:
Mailing Address - City:MENA
Mailing Address - State:AR
Mailing Address - Zip Code:71953-4392
Mailing Address - Country:US
Mailing Address - Phone:479-394-4083
Mailing Address - Fax:
Practice Address - Street 1:600 HIGHWAY 71 N
Practice Address - Street 2:
Practice Address - City:MENA
Practice Address - State:AR
Practice Address - Zip Code:71953-4392
Practice Address - Country:US
Practice Address - Phone:479-394-4083
Practice Address - Fax:479-394-1117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-13
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2289152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5G035OtherMEDICARE GROUP PTAN
AR178511722Medicaid
AR49614OtherMEDICARE INDIVIDUAL PTAN
AR410048684OtherRAIL ROAD MEDICARE
AR49614OtherMEDICARE INDIVIDUAL PTAN