| Boozman-hof Regional Eye Clinic Pa | |
|
3737 W. Walnut, Rogers, AR 72757-1353 | |
| (479) 246-1700 | |
| (479) 631-2629 |
| Full Name | Boozman-hof Regional Eye Clinic Pa |
|---|---|
| Type | Facility |
| Speciality | Ophthalmology |
| Location | 3737 W. Walnut, Rogers, Arkansas |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548234669 | NPI | - | NPPES |
| 112304722 | Medicaid | AR | |
| 101143002 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (Arkansas) | Secondary |
| 207W00000X | Ophthalmology | (Arkansas) | Primary |
| Provider Name | C.scott Woodward |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1992779938 PECOS PAC ID: 2567586514 Enrollment ID: I20100828000023 |
| Provider Name | Daniel T Sines |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1508028218 PECOS PAC ID: 7810043858 Enrollment ID: I20110906000545 |
| Provider Name | Michael Ray Waggoner |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1295963999 PECOS PAC ID: 2365685229 Enrollment ID: I20141022000498 |
| Provider Name | Mary C Sullivan |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1871935122 PECOS PAC ID: 7618199316 Enrollment ID: I20141113000982 |
| Provider Name | Austin P Bell |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1093008302 PECOS PAC ID: 5294971743 Enrollment ID: I20160616000101 |
| Provider Name | Samantha Devlin |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1750732616 PECOS PAC ID: 0648545475 Enrollment ID: I20180626001471 |
| Provider Name | Stephanie Stanley Moss |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1043747595 PECOS PAC ID: 0941566947 Enrollment ID: I20180627003190 |
| Provider Name | Andrew James Hickman |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1407342371 PECOS PAC ID: 1658629936 Enrollment ID: I20180802001334 |
| Provider Name | Ryan Bunch |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1306225214 PECOS PAC ID: 2769762756 Enrollment ID: I20210315001474 |
| Provider Name | Kory A Allen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1992385009 PECOS PAC ID: 3375931413 Enrollment ID: I20220803003161 |
| Provider Name | Mellinda Stewart |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1104490044 PECOS PAC ID: 9234511270 Enrollment ID: I20220808000830 |
| Provider Name | Rebecca Jane Simmons Brown |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1023897253 PECOS PAC ID: 5597104323 Enrollment ID: I20240412003067 |
| Mailing Address | Practice Location Address |
|---|---|
| Boozman-hof Regional Eye Clinic Pa 3737 W. Walnut, P.o. Box 1353, Rogers, AR 72757-1353 Ph: (479) 246-1700 | Boozman-hof Regional Eye Clinic Pa 3737 W. Walnut, Rogers, AR 72757-1353 Ph: (479) 246-1700 |