Provider Demographics
NPI:1184854200
Name:OZARK EYES, PLLC
Entity Type:Organization
Organization Name:OZARK EYES, PLLC
Other - Org Name:OZARK EYES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BEAVERS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:479-799-5751
Mailing Address - Street 1:7058 W SUNSET AVE
Mailing Address - Street 2:SUITE #3
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72762-0680
Mailing Address - Country:US
Mailing Address - Phone:479-361-9933
Mailing Address - Fax:479-361-9937
Practice Address - Street 1:7058 W SUNSET AVE
Practice Address - Street 2:SUITE #3
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-0680
Practice Address - Country:US
Practice Address - Phone:479-361-9933
Practice Address - Fax:479-361-9937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-23
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty