Med Southwest PLLC
Organization Active NPI Optometrist · El Dorado, AR
NPI 1124588405 · NPPES record last updated Jun 30, 2022
Key facts
- NPI
- 1124588405
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- Legal business name
- MED SOUTHWEST PLLC
- Practice address
- 310 Thompson Ave
El Dorado, AR 71730-4569 - Phone
- (870) 862-4216
- Fax
- (870) 862-2423
- NPI assigned
- Mar 22, 2019
- Organization subpart
- No
Authorized official
- Name
- Sue Downes
- Title
- Secretary
- Phone
- (703) 847-8899
Other NPIs on the same Medicare enrollment 8
Other NPIs with the same Medicare PAC ID 15
Corporate family (same tax ID) 8
Practitioners 235
-
Melissa Polk, OD
-
Brittany B. Boyette, O.D.
-
Ronald A Burks, OD
-
Angela Cho, O.D.
-
Frances Louise Davis, O.D.
-
Malcolm Hutchins, O.D.
-
Clemit W Liles III, O.D.
-
Britton Adams, OD
-
Azka Ahmed, OD
-
Joselyn Alumkal, O.D.
-
Hamza Amanullah, OD
-
Mitchell Ray Anderson, O.D.
-
Nadeen Awad, O.D.
-
Steven R Barclay, O.D.
-
Justin Kelly Barnett, O.D.
-
Jessica Barraza, OD
-
Andrea Barsness, O. D.
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Med Southwest, PLLC |
Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses | Accepts assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in AR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190403000952 | AR | Part B Supplier - Clinic/Group Practice | 4082952874 |
Receives reassigned benefits from 27 practitioners 8 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Texarkana, AR; Sherwood, AR; Nashville, AR; Mena, AR; Hope, AR; Magnolia, AR; Arkadelphia, AR; El Dorado, AR… |
| O20220422000973 | AR | DME Supplier - Physician - Optometrist | 4082952874 | Practice locations: El Dorado, AR |
National Provider Directory
- Tax ID family
- Med Southwest PLLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | Yes |
Addresses
Primary practice location
310 Thompson Ave
El Dorado, AR 71730-4569
Mailing address
8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899
Other names
- MyEyeDr.
Other providers in El Dorado, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 30, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.