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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

C WALLACE LILES JR OD PA

Active Organization

C WALLACE LILES JR OD PA is a Optometrist organization located in WALDRON, Arkansas. NPI 1043438807 is currently active in the NPPES registry. Verify at CMS.

Optometrist · WALDRON, AR

Registration Details

NPI Number
1043438807
Provider Type
Organization
NPI Issued
Apr 24, 2007 (19.342363456209 yrs)
Last Updated
Sep 1, 2009
License
AR2331 (AR)

Practice Information

Address
72 W 2ND ST
WALDRON, AR, 729587085
Browse AR providers · Browse ZIP 72958
Phone
4796375598
Fax
4796371195
Primary Specialty
Optometrist
152W00000X
Data sourced from the NPPES National Provider Identifier registry. Healthcare organizations registered in NPPES are assigned an NPI number for use in insurance billing and claims. This information is for informational purposes only. For official verification, use the NPPES NPI Registry.