Individual
MICHAEL C ELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
310 THOMPSON AVE, EL DORADO, AR 71730-4569
(870) 862-4216
(870) 862-9011
Mailing address
310 THOMPSON AVE, EL DORADO, AR 71730-4569
(870) 862-4216
(870) 862-9011
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2647
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
188676722
—
AR
01
—
P00986548
RAILROAD MEDICARE
AR
Enumeration date
08/05/2010
Last updated
01/26/2012
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