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General NPI Number Information
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NPI Number | 1346377678
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Entity Type | Organization
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Legal Business Name | DR. DALE LADD PA
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 11/12/2020
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Provider Practice Location Address
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Address Line | 1119 N SAINT LOUIS
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City | BATESVILLE
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State | AR
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Zip | 72501-9458
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Country | US
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Telephone | 870-793-6857
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Fax |
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Provider Business Mailing Address
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Address Line | 1119 N SAINT LOUIS
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City | BATESVILLE
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State | AR
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Zip | 72501-9458
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Country | US
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Telephone | 870-793-6857
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | JAMES DALE LADD
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Credential | OD
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Telephone | 870-793-6857
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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 | AR2425
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License Number State | AR
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