Provider Demographics
NPI:1871807123
Name:EYECARE ASSOCIATES, LLC
Entity type:Organization
Organization Name:EYECARE ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / DOCTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CLIFTON
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:RIDINGS
Authorized Official - Suffix:JR
Authorized Official - Credentials:OD
Authorized Official - Phone:501-791-7117
Mailing Address - Street 1:3929 MCCAIN BLVD STE G07A
Mailing Address - Street 2:MCCAIN MALL
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72116-8005
Mailing Address - Country:US
Mailing Address - Phone:501-791-7117
Mailing Address - Fax:
Practice Address - Street 1:3929 MCCAIN BLVD STE G07A
Practice Address - Street 2:MCCAIN MALL
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72116-8005
Practice Address - Country:US
Practice Address - Phone:501-791-7117
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-28
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5G649Medicare PIN