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Organization

RICHARD W WIKE O D PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RICHARD W WIKE OD (PRESIDENT)
(479) 855-0009
Entity
Organization

Contact information

Practice address
2829 BELLA VISTA WAY, BELLA VISTA, AR 72714-3709
(479) 855-0009
(479) 876-7105
Mailing address
2829 BELLA VISTA WAY, BELLA VISTA, AR 72714-3709
(479) 855-0009
(479) 876-7105

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
AR2256
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
159680722
AR
Enumeration date
02/13/2007
Last updated
01/19/2010
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