Provider Demographics
NPI:1578566865
Name:WRIGHT, SABRE AYERS (OD)
Entity Type:Individual
Prefix:
First Name:SABRE
Middle Name:AYERS
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:SABRE
Other - Middle Name:AYERS
Other - Last Name:YOCHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 2417
Mailing Address - Street 2:519 N WILLOW
Mailing Address - City:HARRISON
Mailing Address - State:AR
Mailing Address - Zip Code:72601
Mailing Address - Country:US
Mailing Address - Phone:870-741-2787
Mailing Address - Fax:870-741-6714
Practice Address - Street 1:519 N WILLOW
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:AR
Practice Address - Zip Code:72601
Practice Address - Country:US
Practice Address - Phone:870-741-2787
Practice Address - Fax:870-741-6714
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-31
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2445152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR49703OtherBLCR AND OTHER ID NUMBER
AR5C405OtherCLINIC NUMBER
AR49703Medicare UPIN
AR5C405OtherCLINIC NUMBER
ARU82550Medicare UPIN