C. Wallace Liles Jr. is a Mena, Arkansas based male Optometrist with 49 years of experience in Optometry. He completed his graduation from University Of Houston - College Of Optometry in 1975. He accepts the Medicare-approved amount. Patients will not be billed for any more than the Medicare deductible and coinsurance. Active license number of C. Wallace Liles Jr. is AR2331 for Optometry in Arkansas. C. Wallace Liles Jr. 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. He 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. He is a eye health care professional who is state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
Complete Profile:
C. Wallace Liles Jr. speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
Specialization:
Optometry
Credentials:
O.D.
Experience:
49+ years
Medical School Attended:
University Of Houston - College Of Optometry
Graduation Year:
1975
Gender:
Male
Accepts Medicare Assignment:
Yes
Practice Address:
208 Morrow St S, Mena, Arkansas, 71953-2510
Phone:
479-394-4215
Fax:
479-394-3455
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
PAC ID:
5294711370
Enrollment ID:
I20090630000437
NPI Number:
1184620049
NPI Enumeration Date:
24 Jun, 2005
NPI Last Update On:
03 Jun, 2019
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for C. Wallace Liles Jr. are as mentioned below.
License Number
Specialization
State
Status
AR2331
Optometry
Arkansas
Primary
Group Practice:
Group practices are run by a group of physicians who share their premises and other resources. Following list states all the group name
with which C. Wallace Liles Jr. has association with along with the number of members in that group.
Organization Name (Group PAC ID)
Members
Med Southwest Pllc (4082952874)
181
Other Medical Identifiers:
Other legacy medical identifiers associated with C. Wallace Liles Jr. such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
103836722
Medicaid
Arkansas
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
703j Highway 71 N, Mena, Arkansas
Zip:
71953-4395
Phone Number:
479-394-4215
Fax Number:
479-394-3455
Patients can reach C. Wallace Liles Jr. at 208 Morrow St S, Mena, Arkansas or can call to book an appointment on 479-394-4215. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 11 March, 2024.