Moulton Optical Department
NPI #1235304924 in Fort Smith, Arkansas
Provider Information
- NPI Number
- 1235304924
- Entity Type
- Organization
- Organization Name
- Moulton Optical Department
- Primary Specialty
- Eyewear Supplier
- Enumeration Date
- Apr 24, 2008
- Last Updated
- Jan 24, 2019
Practice Location
- Address
- 5518 ELLSWORTH RD
- City
- Fort Smith
- State
- Arkansas
- ZIP Code
- 72903-3222
- Phone
- (479) 646-3937
Authorized Official
- Name
- DR. EVERETT CROCKETT MOULTON III, M.D.
- Title
- PRESIDENT
- Phone
- (479) 646-3937
Specialties & Taxonomy Codes
| Specialty |
|---|
| Eyewear Supplier |
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