Witherspoon, John Bradley
Witherspoon, John Bradley is an individual health care provider with primary practice located at 1155 Hwy 65 North , Conway AR 72032. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Witherspoon, John Bradley can be contacted via phone (501) 328-9500.Contact Information
Primary practice address
1155 Hwy 65 North
Conway AR 72032
Phone: (501) 328-9500
Fax: (501) 328-5148
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2272 | Arkansas |
Profile Details
| NPI number | 1336131887 |
|---|---|
| LBN Legal business name | Witherspoon, John Bradley |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 19th, 2005 |
| Last updated | Aug 9th, 2010 - about 15 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 | 1336131887 | NPPES |
| Arkansas | MEDICAID | 106399722 |
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