Healthcare Provider Details

I. General information

NPI: 1740107796
Provider Name (Legal Business Name): SPENCER HAVEL OD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 HORIZON DR STE 15
BRYANT AR
72022-9095
US

IV. Provider business mailing address

2900 HORIZON DR STE 15
BRYANT AR
72022-9095
US

V. Phone/Fax

Practice location:
  • Phone: 501-653-2020
  • Fax: 501-653-7407
Mailing address:
  • Phone: 501-653-2020
  • Fax: 501-653-7407

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2911
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: