| Dr Wayne Provines, O D | |
|
314 Mdg/sgo, 1090 Arnold Dr, Little Rock Afb, AR 72099-0001 | |
| (501) 987-8702 | |
| Not Available |
| Full Name | Dr Wayne Provines |
|---|---|
| Gender | Male |
| Speciality | Optometrist - Occupational Vision |
| Location | 314 Mdg/sgo, 1090 Arnold Dr, Little Rock Afb, Arkansas |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376506543 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152WX0102X | Optometrist - Occupational Vision | 9256 (Arkansas) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Wayne Provines, O D 2812 Gray Fox Ln, Jacksonville, AR 72076-2629 Ph: (501) 985-1185 | Dr Wayne Provines, O D 314 Mdg/sgo, 1090 Arnold Dr, Little Rock Afb, AR 72099-0001 Ph: (501) 987-8702 |
Patricia Ellen Hoogeveen, O.D. Optometrist Medicare: Medicare Enrolled Practice Location: 1090 Arnold Dr, Little Rock Afb, AR 72099 Phone: 501-987-8702 | |
Benjamin Lee Reberger Iii, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1090 Arnold Dr, Little Rock Afb, AR 72099 Phone: 501-987-8702 | |
Roger Lafe Benjamin, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 314 Mdos/sgoae, 1090 Arnold Drive, Little Rock Afb, AR 72099 Phone: 501-987-8072 |