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General NPI Number Information
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NPI Number | 1184854200
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Entity Type | Organization
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Legal Business Name | OZARK EYES, PLLC
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Dates
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Enumeration Date | 07/23/2009
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Last Update Date | 07/23/2009
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Provider Practice Location Address
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Address Line | 7058 W SUNSET AVE SUITE #3
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City | SPRINGDALE
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State | AR
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Zip | 72762-0680
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Country | US
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Telephone | 479-361-9933
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Fax | 479-361-9937
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Provider Business Mailing Address
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Address Line | 7058 W SUNSET AVE SUITE #3
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City | SPRINGDALE
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State | AR
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Zip | 72762-0680
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Country | US
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Telephone | 479-361-9933
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Fax | 479-361-9937
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Authorized Official
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Title or Position | MEMBER/OWNER
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Name | DR. JUSTIN BEAVERS
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Credential | O.D.
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Telephone | 479-799-5751
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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 |
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License Number State |
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