Home » Arkansas » 72958 » C Wallace Liles Jr Od Pa

C Wallace Liles Jr Od Pa

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.

physician-icon Basic Information

Practice Location 72 W 2nd St, Waldron, AR 72958-7085, US
Practice Location Phone479-637-5598
Practice Location Fax479-637-1195
Other Organization NameLILES VISION CLINIC
Other Organization Name TypeFormer Legal Business Name
NPI ?1043438807
Entity TypeOrganization
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-icon Specialties & Licenses of C Wallace Liles Jr Od Pa

SpecialtySpecializationLicenseLicense State
Optometrist AR2331Arkansas

legacy-id-icon Legacy Provider IDs of C Wallace Liles Jr Od Pa

Provider IdIssuer StateIssuer TypeIssuer

official-icon Authorized Official of C Wallace Liles Jr Od Pa

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/PositionDR.
Authorized Official Phone Number479-637-5598