Shaver, Jonathan F
Shaver, Jonathan F is an individual health care provider with primary practice located at 594 E Millsap , Fayetteville AR 72703-1345. He recently has 3 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Pediatrics. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Shaver, Jonathan F can be contacted via phone (479) 442-2020.Contact Information
Primary practice address
594 E Millsap
Fayetteville AR 72703-1345
Phone: (479) 442-2020
Fax: (479) 521-3988
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Eye and Vision Services Providers / Optometrist | 152W00000X | 2549 | Arkansas |
Eye and Vision Services Providers / Optometrist | 152W00000X | 558 | New Mexico |
Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | 2549 | Arkansas |
Eye and Vision Services Providers / Pediatrics | 152WP0200X | 2549 | Arkansas |
Profile Details
NPI number | 1790764454 |
---|---|
LBN Legal business name | Shaver, Jonathan F |
Credentials | Doctor of Optometry (OD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jan 11th, 2006 |
Last updated | Sep 11th, 2012 - about 12 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 | 1790764454 | NPPES |
Arkansas | MEDICAID | 157556722 |
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