MEDICARE: DR. STEVEN B STILES O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	2253	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	49372	OTHER	AR	BCBS

General Provider Information

NPI Number	:	1699747568
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN B STILES O.D.

Provider Business Mailing Address
First Line	:	2401 S WALDRON RD
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72903-3736
Country	:	US
Telephone Number	:	479-452-2020
Fax Number	:	479-452-4759

Provider Business Practice Location Address
First Line	:	2401 S WALDRON RD
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72903-3736
Country	:	US
Telephone Number	:	479-452-2020
Fax Number	:	479-452-4759

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2006
Last Update Date	:	11/15/2018

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