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Individual

TIM E ELCYZYN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
3805 W 28TH AVE, PINE BLUFF, AR 71603-4774
(870) 536-3100
(870) 536-3100
Mailing address
3805 W 28TH AVE, PINE BLUFF, AR 71603-4774
(870) 536-3100
(870) 536-3100

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2569
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00362854
RAILROAD MEDICARE PIN
Enumeration date
08/10/2006
Last updated
03/28/2008
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