Healthcare Provider Details

I. General information

NPI: 1174010342
Provider Name (Legal Business Name): MATTHEW SCHAFFNER OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2018
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 N COLLEGE AVE
FAYETTEVILLE AR
72703-1944
US

IV. Provider business mailing address

1100 N COLLEGE AVE
FAYETTEVILLE AR
72703-1944
US

V. Phone/Fax

Practice location:
  • Phone: 479-444-5093
  • Fax: 479-587-6105
Mailing address:
  • Phone: 479-444-5093
  • Fax: 479-587-6105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number4031
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: