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Contact Information

ENNEN EYE CENTER, P.A.
3312 S 70TH ST
FORT SMITH, AR72903-5052
 Phone: 479-452-7800
 Fax: 479-452-9486
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Ophthalmology

207W00000X 18 Physician/Ophthalmology
 

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for ENNEN EYE CENTER, P.A.

NPI # 1003877150
LBN Legal business name ENNEN EYE CENTER, P.A.
Authorized official RANDY ENNEN - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 03/29/2006
Last updated 04/12/2012 - About 14 years ago
Identifiers
AR Medicaid 152215002
OK Medicaid 100177380B
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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