Organization
TEAGUE EYE CARE CENTER PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AUDIE M. TEAGUE O.D. (PRESIDENT)
(870) 836-7319
Entity
Organization
Contact information
Practice address
1421 COUNTRY CLUB RD, CAMDEN, AR 71701-4507
(870) 836-7319
(870) 836-7310
Mailing address
PO BOX 953, CAMDEN, AR 71711-0953
(870) 836-7319
(870) 836-7310
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2325
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
161690722
—
AR
01
—
5632710001
DME
AR
01
—
DE4369
RAILROAD MEDICARE
AR
Enumeration date
09/26/2006
Last updated
04/26/2011
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