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General NPI Number Information
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NPI Number | 1669430914
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Entity Type | Individual
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Provider Name | R DAN BOST OD PA
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Gender | Male
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Dates
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Enumeration Date | 05/03/2006
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Last Update Date | 11/05/2010
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Provider Practice Location Address
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Address Line | 2733 CADDO ST
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City | ARKADELPHIA
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State | AR
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Zip | 71923-5309
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Country | US
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Telephone | 870-246-2932
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Fax | 870-230-1552
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Provider Business Mailing Address
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Address Line | 2733 CADDO ST
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City | ARKADELPHIA
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State | AR
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Zip | 71923-5309
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Country | US
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Telephone | 870-246-2932
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Fax | 870-230-1552
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 2306
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License Number State | AR
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