Laster, Shane F
Laster, Shane F is an sole proprietor health care provider with primary practice located at 8500 S 36Th Ter , Fort Smith AR 72908-8880. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Laster, Shane F can be contacted via phone (479) 242-2020.Contact Information
Primary practice address
8500 S 36Th Ter
Fort Smith AR 72908-8880
Phone: (479) 242-2020
Fax: (479) 242-1919
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2427 | Arkansas |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2135 | Oklahoma |
Profile Details
| NPI number | 1215998331 |
|---|---|
| LBN Legal business name | Laster, Shane F |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 29th, 2006 |
| Last updated | Mar 8th, 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 | 1215998331 | NPPES |
| Arkansas | MEDICAID | 130679722 | |
| Arkansas | MEDICAID | 100764560A |
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