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Organization

LANE EYE CARE CENTER, P.A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MILTON J LANE O.D. (PRESIDENT)
(501) 982-8833
Entity
Organization

Contact information

Practice address
625 N 1ST ST STE A, STE A, JACKSONVILLE, AR 72076-4138
(501) 982-8833
(501) 985-6806
Mailing address
PO BOX 99, JACKSONVILLE, AR 72078-0099
(501) 982-8833
(501) 985-6806

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2219
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
110945722
AR
Enumeration date
05/22/2007
Last updated
03/05/2008
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