NPI 1235304924

Moulton Optical Department

Organisation Eyewear Supplier Fort Smith, AR

Practice location

Address: 5518 Ellsworth Rd, Fort Smith, AR 72903-3222
Phone: (479) 646-3937
Fax: (479) 646-3605

Authorised official

Name: Everett Crockett Moulton
Title: President
Phone: (479) 646-3937

Registered specialties

Eyewear Supplier Primary

Suppliers Taxonomy 332H00000X Licence C4990 (AR)

Other Eyewear Supplier providers in Arkansas →

Registry record

NPI: 1235304924
Entity type: Organization
NPI issued: 24 Apr 2008
Record last updated: 24 Jan 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.