Organization
OPTICAL SHOP
Active
Parent organization
EYE GROUP LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
EYE GROUP LLC
Authorized official
DR. ROBERT KNOX (PRESIDENT)
(479) 782-8892
Entity
Organization
Contact information
Practice address
7901 DALLAS ST, FORT SMITH, AR 72903-4281
(479) 782-8892
(479) 782-8840
Mailing address
7901 DALLAS ST, FORT SMITH, AR 72903-4281
(479) 782-8892
(479) 782-8840
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100768130B
—
OK
05
—
128041002
—
AR
01
—
CQ2384
RAILROAD MEDICARE
AR
Enumeration date
11/02/2006
Last updated
04/30/2018
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