DR. JERRY B PARK (NPI# 1235254095) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235254095 |
| Entity Type | Individual |
| Full Name | DR. JERRY B PARK |
| Credential | OP |
| Practice Address |
291 North First Street Jacksonville AR 72076 |
| Practice Telephone | 5019821100 |
| Practice Fax Number | 5019820323 |
| Mailing Telephone | 5019821100 |
| Mailing Fax Number | 5019820323 |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | OP1100081 | AR | Eye and Vision Services Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588707764 | Jerry Park | Chiropractor | 224 S Main St Ste 1, Centerville, UT 84014-2206 | 2007-02-15 |
| 1457381360 | Jerry Edward Park | Counselor | 184 Business Park Drive, Suite 200, Virginia Beach, VA 23462-6533 | 2006-07-04 |
| 1245337153 | Jerry W. Park | Family Medicine | 9222 N Newport Hwy, Ste 1, Spokane, WA 99218-1235 | 2006-09-20 |
| Street Address |
291 NORTH FIRST STREET |
| City | JACKSONVILLE |
| State | AR |
| Zip Code | 72076 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598396046 | Jennifer Michelle Price | Licensed Practical Nurse | 2400 West Main, Jacksonville, AR 72076 | 2020-02-03 |
| 1912464009 | Stat Home Health - Cenark LLC | Home Health | 1410 Braden Street, Jacksonville, AR 72076 | 2019-02-25 |
| 1649797671 | Caring Hearts Counseling, LLC | Case Management | 111 Marble Drive, Jacksonville, AR 72076 | 2017-08-30 |
| 1376071340 | Anne Elizabeth Houtchens | Speech-Language Pathologist | 2701 Tp White Drive, Jacksonville, AR 72076 | 2017-06-02 |
| 1881140648 | Jacksonville North Pulaski School District | Local Education Agency (LEA) | 1414 West Main, Jacksonville, AR 72076 | 2016-08-31 |
| 1134599772 | Jeremiah Melson Fleeman | Occupational Therapist | 2701 Tpwhite Drive, Jacksonville, AR 72076 | 2015-09-25 |
| 1821424565 | Kasey Michele Leeson | Social Worker | 2520 W. Main St., Jacksonville, AR 72076 | 2013-09-25 |
| 1407104052 | Cesalie Deonne Wallace | Nurse Practitioner | 3000 North First Street, Jacksonville, AR 72076 | 2012-08-29 |
| 1952660995 | Joshua Aaron Hill | Case Manager/Care Coordinator | 2126 N. 1st St Suite F, Jacksonville, AR 72076 | 2012-05-11 |
| 1396023156 | Syreeta Tucker | Case Manager/Care Coordinator | 1109 Burman, Jacksonville, AR 72076 | 2011-07-28 |
| Find all providers in zip 72076 | ||||
| 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 |
|---|---|---|---|---|
| 1215553367 | Myeyedr Optometry of Florida, LLC | Optometrist | 2152 3rd St S # 60, Jacksonville, FL 32250-4019 | 2020-06-24 |
| 1154945814 | Kaitlin Jaquett Brown | Optometrist | 4788 Hodges Blvd Ste 205, Jacksonville, FL 32224-7223 | 2020-05-29 |
| 1831745660 | National Vision Inc | Optometrist | 14021 Lunar Drive, Unit 1, Jacksonville, FL 32218-7290 | 2019-08-16 |
| 1144876475 | Myeyedr Optometry of Florida, LLC | Optometrist | 11945 San Jose Blvd Ste 202, Jacksonville, FL 32223-1612 | 2019-08-13 |
| 1295294742 | Myeyedr Optometry of Florida, LLC | Optometrist | 13760 Old Saint Augustine Rd Ste 102, Jacksonville, FL 32258-5492 | 2019-03-14 |
| 1922578558 | Fatima Hussain Crofton | Optometrist | 7051 Southpoint Parkway S 300, Jacksonville, FL 32216 | 2018-11-27 |
| 1356820211 | Nisha Patel | Optometrist | 10300 Southside Blvd Ste 114, Jacksonville, FL 32256-6759 | 2018-08-11 |
| 1538650155 | Vision Today Pllc | Optometrist | 9365-2 Atlantic Blvd, Jacksonville, FL 32225-8203 | 2018-05-21 |
| 1447765748 | Sudduth Vision Pllc | Optometrist | 8000 Parramore Rd., Jacksonville, FL 32244 | 2017-12-08 |
| 1851806657 | Ann Huynh Nguyen | Optometrist | 9041 Southside Blvd Ste 174, Jacksonville, FL 32256-8482 | 2017-12-04 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 72076 |
Please comment or provide details below to improve the information on DR. JERRY B PARK.
| 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.