C WALLACE LILES JR OD PA (NPI# 1043438807) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043438807 |
| Entity Type | Organization |
| Organization Name | C WALLACE LILES JR OD PA |
| Other Organization Name | LILES VISION CLINIC |
| Practice Address |
72 W 2nd St Waldron AR 72958-7085 |
| Practice Telephone | 4796375598 |
| Practice Fax Number | 4796371195 |
| Mailing Telephone | 4796375598 |
| Mailing Fax Number | 4796371195 |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2009-09-01 |
| Authorized Official Name | DR. C. WALLACE LILES JR. (DR.) |
| Authorized Official Telephone | 4796375598 |
| Authorized Official Credential | O.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | AR2331 | AR | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 125850722 | 05 |
| Other Name | Type Code |
|---|---|
| Liles Vision Clinic | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316165178 | C Wallace Liles Jr Od Pa | Optometrist | 404d E Collin Raye Dr, De Queen, AR 71832-4149 | 2007-04-24 |
| Street Address |
72 W 2ND ST |
| City | WALDRON |
| State | AR |
| Zip Code | 72958-7085 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235589250 | Kah Development 4, LLC | Home Health | 72 W 2nd St, Waldron, AR 72958-7085 | 2016-06-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992212013 | River Valley Primary Care Services, Inc | Family Medicine | 2074 Rice Road, Waldron, AR 72958 | 2018-01-10 |
| 1952814857 | Health-wise Pharmacy Pllc | Pharmacy | 47 S Hwy 71 Bypass, Waldron, AR 72958 | 2017-11-14 |
| 1992073225 | Western Arkansas Couseling & Guidance Center, Inc.-scott County | Community/Behavioral Health | 1857 Rice St, Waldron, AR 72958 | 2011-12-01 |
| 1649445859 | Western Arkansas Counseling & Guidance Center, Inc.-scott County | Community/Behavioral Health | 1857 Rice Street, Waldron, AR 72958 | 2008-04-29 |
| 1851877849 | David Reed Harris | Counselor | 1857 Rice Street, Waldron, AR 72958-0312 | 2018-07-13 |
| 1336252980 | Robbins Mark Bailey | Dentist | 2114 Rice Street, Waldron, AR 72958-0907 | 2006-08-17 |
| 1306945159 | R. Mark Bailey,d.d.s.,p.a. | Dentist | 2114 Rice Street, Waldron, AR 72958-0907 | 2006-09-21 |
| 1639609381 | Harps Food Stores, Inc | Pharmacy | 1350 W 6th St, Waldron, AR 72958-2600 | 2017-06-15 |
| 1518977669 | State of Arkansas | Home Health | 487 West 6th Street, Scott County Health Unit, Waldron, AR 72958-4630 | 2006-08-09 |
| 1912393836 | Hightower and Shepard Group LLC | Assisted Living Facility | 520 W 2nd St, Waldron, AR 72958-7057 | 2015-04-07 |
| Find all providers in zip 72958 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639498918 | Doyl Erwin Broomfield | Optometrist | 300 Elm St, Waldron, AR 72958-7461 | 2010-05-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497373088 | Taylor Renz | Optometrist | 1225 W Beebe Capps Expy, Searcy, AR 72143-5179 | 2020-07-09 |
| 1932733185 | Ashley Mcgee | Optometrist | 723 Falls Blvd S Ste A, Wynne, AR 72396-3509 | 2020-02-26 |
| 1972144566 | Randy Bell Od Pllc | Optometrist | 101 W Walnut St, Rogers, AR 72756-6662 | 2019-10-04 |
| 1881241792 | Radiant Eye Care Optometric Corporation | Optometrist | 1210 Jtl Pkwy E Ste 103, Springdale, AR 72762-7019 | 2019-08-25 |
| 1457905903 | Heather Snyder | Optometrist | 1021 South Waldron Road, Fort Smith, AR 72903 | 2019-08-01 |
| 1568024230 | Lawrence Allen King IIi | Optometrist | 4300 Rogers Ave Ste 46, Fort Smith, AR 72903-3152 | 2019-07-02 |
| 1306406269 | Idell Marie Mitchell | Optometrist | Eye Clinic, 1100 N College Ave, Fayetteville, AR 72703 | 2019-06-13 |
| 1417413717 | Med Southwest, Pllc | Optometrist | 114 E 49th St, Texarkana, AR 71854-2117 | 2019-02-12 |
| 1588120877 | Med Southwest, Pllc | Optometrist | 2510 N Hervey St, Hope, AR 71801-8419 | 2019-02-12 |
| 1093279275 | Piper's Vision Xpress, LLC | Optometrist | 50 Paul Wood Lane, Mountian Home, AR 72653 | 2019-01-22 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.