Harry R Denison, O.D.
Individual provider Active NPI Optometrist · Fordyce, AR
NPI 1003920653 · NPPES record last updated May 22, 2009
Key facts
- NPI
- 1003920653
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 2050 (AR)
- Practice address
- 312 N Spring St
Fordyce, AR 71742-3318 - Phone
- (870) 352-2167
- Fax
- (870) 352-8883
- NPI assigned
- Aug 19, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2050 | AR | Yes |
Addresses
Primary practice location
312 N Spring St
Fordyce, AR 71742-3318
Mailing address
PO Box 725
Fordyce, AR 71742-0725
Phone (870) 352-2167
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 102066722 | Medicaid | AR |
Other providers in Fordyce, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 22, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.