Daniel, Lance
Daniel, Lance is an sole proprietor health care provider with primary practice located at 4201 N Shiloh Dr , Fayetteville AR 72703-5180. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Daniel, Lance can be contacted via phone (479) 444-8704.Contact Information
Primary practice address
4201 N Shiloh Dr
Fayetteville AR 72703-5180
Phone: (479) 444-8704
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2371 | Arkansas |
Profile Details
| NPI number | 1003957374 |
|---|---|
| LBN Legal business name | Daniel, Lance |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 9th, 2007 |
| Last updated | Jul 15th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1003957374 | NPPES |
| Arkansas | Other | 710744825 | TAX ID |
| Arkansas | MEDICAID | 117012722 | TAX ID |
| Arkansas | Other | 117012722 | TAX ID |
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