Individual
MRS. KATHLEEN H CHUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
25 E. WALNUT, PARIS, AR 72855
(479) 963-2661
(479) 963-6821
Mailing address
P.O. BOX 647, PARIS, AR 72855
(479) 963-2661
(479) 963-6821
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2564
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
159544722
—
AR
05
—
159554722
—
AR
01
—
5N406
BLUE CROSS AND BLUE SHIEL
AR
Enumeration date
04/04/2006
Last updated
04/25/2011
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