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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 MENA, Arkansas. NPI 1275750606 is currently active in the NPPES registry. Verify at CMS.

Optometrist · MENA, AR

Registration Details

NPI Number
1275750606
Provider Type
Organization
NPI Issued
Apr 19, 2007 (19.33258687785 yrs)
Last Updated
Jun 17, 2009
License
AR2331 (AR)

Practice Information

Address
703J HIGHWAY 71 N
MENA, AR, 719534395
Browse AR providers · Browse ZIP 71953
Phone
4793944215
Primary Specialty
Optometrist
152W00000X

Other Optometrist Organizations in MENA, AR

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.