Provider Demographics
NPI:1346301736
Name:HURST, ROBERT KYLE (OD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:KYLE
Last Name:HURST
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1412 SE 14TH ST
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-6812
Mailing Address - Country:US
Mailing Address - Phone:479-271-9700
Mailing Address - Fax:479-271-9771
Practice Address - Street 1:1412 SE 14TH ST
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-6812
Practice Address - Country:US
Practice Address - Phone:479-271-9700
Practice Address - Fax:479-271-9771
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2448152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist