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Individual

EDDIE SCOTT EPPERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D

Contact information

Practice address
608 E NORTH ST, MAGNOLIA, AR 71753-3121
(870) 234-6241
(870) 234-3771
Mailing address
608 E NORTH ST, MAGNOLIA, AR 71753-3121
(870) 234-6241
(870) 234-3771

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
5994T
TX
152W00000X
Optometrist
Primary
AR2327
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0057FA
BCBS OF TEXAS
TX
01
410011307
RAIL ROAD MEDICARE
AR
Enumeration date
08/03/2006
Last updated
03/06/2012
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