Wallace W Towle, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2196 Issued in AR

Practice address

1827 Central Ave
Hot Springs National Park, AR 71901-6848

Phone

(501) 624-5492

Fax

(501) 321-0001

NPI assigned

Dec 11, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513036800000",
    "number": "1710047857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 549",
            "city": "HOT SPRINGS NATIONAL PARK",
            "state": "AR",
            "postal_code": "719020549",
            "telephone_number": "501-624-5492",
            "fax_number": "501-321-0001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1827 CENTRAL AVE",
            "city": "HOT SPRINGS NATIONAL PARK",
            "state": "AR",
            "postal_code": "719016848",
            "telephone_number": "501-624-5492",
            "fax_number": "501-321-0001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOWLE",
        "first_name": "WALLACE",
        "middle_name": "W",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2017-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102349722",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Leigh Stevens, LPC
• Sandi Kay Sturdivant, PTA
• Tanna Sutter, LPN
• Jeffrey George Tauth, M.D.
• Monica Terrazas, LPN
• Dasaradha Uyyala, MD
• Trinity Van Dusen, QBHP
• Ariana Vazquez, D.D.S
• Vine Counseling LLC
• Michael Watson II, PH.D

• Optometrist in Hot Springs National Park, AR
• Providers in Hot Springs National Park, AR by specialty
• Optometrist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.