Organization
COCKRUM VISION CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BERNADINA C. PAINE (OFFICE MANAGER)
(870) 425-1112
Entity
Organization
Contact information
Practice address
2183 HIGHWAY 62 W, MOUNTAIN HOME, AR 72653-6500
(870) 425-1112
(870) 425-1278
Mailing address
2183 HIGHWAY 62 W, MOUNTAIN HOME, AR 72653-6500
(870) 425-1112
(870) 425-1278
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
AR2230
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110615722
—
AR
Enumeration date
07/02/2009
Last updated
12/09/2015
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