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General NPI Number Information
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NPI Number | 1851299093
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Entity Type | Organization
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Legal Business Name | NWA VISION GROUP
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Dates
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Enumeration Date | 10/28/2026
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Last Update Date | 10/28/2026
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Provider Practice Location Address
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Address Line | 2901 HIGHWAY 412 E
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City | SILOAM SPRINGS
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State | AR
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Zip | 72761-8673
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Country | US
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Telephone | 479-238-0257
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Fax |
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Provider Business Mailing Address
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Address Line | 3702 NW MOUNTAINVIEW RD
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City | BENTONVILLE
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State | AR
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Zip | 72712-8092
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Country | US
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Telephone | 573-450-5459
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST/OWNER
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Name | JACOB LEET
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Credential | OD
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Telephone | 573-450-5459
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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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