Healthcare Provider Details

I. General information

NPI: 1184041873
Provider Name (Legal Business Name): HAYDEN SOWERS OPTOMETRY PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2014
Last Update Date: 08/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3609 HIGHWAY 367 N
BALD KNOB AR
72010-9404
US

IV. Provider business mailing address

2402 HARRISON ST
BATESVILLE AR
72501-7421
US

V. Phone/Fax

Practice location:
  • Phone: 870-834-3339
  • Fax:
Mailing address:
  • Phone: 870-834-3339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2666
License Number StateAR

VIII. Authorized Official

Name: DR. HAYDEN HARPER SOWERS
Title or Position: DOCTOR/OWNER
Credential: O.D.
Phone: 870-834-3339