NPI 1003877150 · live from the CMS NPI Registry
Ennen Eye Center, P.A.
Ophthalmology in Fort Smith, AR. National Provider Identifier 1003877150, active.
NPI record
| NPI | 1003877150 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Ophthalmology 207W00000X |
| Practice location | 3312 S 70th St, Fort Smith, AR 72903 |
| Practice phone | 479-452-7800 |
| Enumerated | March 29, 2006 |
| Last updated | April 12, 2012 |
| Authorized official | Randy Ennen, President |
| Other names | Ennen Eye Center |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist | 152W00000X | — |
| Ophthalmology primary | 207W00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.