Healthcare Provider Details

I. General information

NPI: 1558320325
Provider Name (Legal Business Name): BOOZMAN-HOF REGIONAL EYE CLINIC PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2006
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3737 W WALNUT ST
ROGERS AR
72756-1839
US

IV. Provider business mailing address

3737 W WALNUT ST
ROGERS AR
72756-1839
US

V. Phone/Fax

Practice location:
  • Phone: 479-246-1730
  • Fax: 479-936-8799
Mailing address:
  • Phone: 479-246-1700
  • Fax: 479-631-2629

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: SUSAN L WADE
Title or Position: MANAGER
Credential:
Phone: 316-619-3277