Organization
SIMMONS EYE CARE CLINIC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSELL T. SIMMONS O.D. (VICE PRESIDENT)
(501) 778-2363
Entity
Organization
Contact information
Practice address
113 W CARPENTER ST, BENTON, AR 72015-3317
(501) 778-2363
(501) 778-5329
Mailing address
113 W CARPENTER ST, BENTON, AR 72015-3317
(501) 778-2363
(501) 778-5329
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2329
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0250800001
PALMETTO DURABLE MEDICAL EQUIPMENT
AR
05
—
105507022
—
AR
05
—
119106722
—
AR
05
—
139616722
—
AR
05
—
161893722
—
AR
01
—
49956
MEDICARE ID#
AR
Enumeration date
10/07/2005
Last updated
08/13/2024
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