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General NPI Number Information
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NPI Number | 1154533776
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Entity Type | Organization
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Legal Business Name | ROBERT W SMALLING OD PA
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 07/31/2012
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Provider Practice Location Address
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Address Line | 119 N MAIN ST
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City | WARREN
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State | AR
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Zip | 71671-2714
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Country | US
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Telephone | 870-226-6731
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Fax | 870-226-7894
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Provider Business Mailing Address
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Address Line | 119 N MAIN ST
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City | WARREN
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State | AR
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Zip | 71671-2714
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Country | US
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Telephone | 870-226-6731
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Fax | 870-226-7894
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT W SMALLING
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Credential | O.D.
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Telephone | 870-226-6731
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2179
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License Number State | AR
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