C Wallace Liles Jr Od Pa is a health care provider in Waldron, AR. In this page you will find its mailing address, practice location, phone number, specialty etc.
|Practice Location||72 W 2nd St, Waldron, AR 72958-7085, US|
|Practice Location Phone||479-637-5598|
|Practice Location Fax||479-637-1195|
|Legal Business Name||C WALLACE LILES JR OD PA|
|Other Organization Name||LILES VISION CLINIC|
|Other Organization Name Type||Former Legal Business Name|
|Enumeration Date ?||Apr 24, 2007|
|Last Update Date ?||Sep 1, 2009|
NPI: National Provider Identifier issued to health care providers by Centers for Medicare and Medicaid Services (CMS).
|Specialty||Provider Type||Specialization||License||License State|
|Optometrist||Eye and Vision Services Providers||AR2331||Arkansas|
|Provider Id||Issuer State||Issuer Type||Issuer|
An authorized official is an appointed official with the legal authority to make changes and/or updates to the C Wallace Liles Jr Od Pa's status and to commit the provider to fully abide by the laws and regulations relating to the National Provider Identifier (NPI).
|Authorized Official||Dr. C. Wallace Liles (O.D.)|
|Authorized Official Title/Position||DR.|
|Authorized Official Phone Number||479-637-5598|