Provider Demographics
NPI:1639467426
Name:DOLVEN, JULIE M (OD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:M
Last Name:DOLVEN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:17711 CHENAL PKWY
Mailing Address - Street 2:STE I117
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-5810
Mailing Address - Country:US
Mailing Address - Phone:870-623-6221
Mailing Address - Fax:
Practice Address - Street 1:17711 CHENAL PKWY
Practice Address - Street 2:SPACE I-117
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72223-5808
Practice Address - Country:US
Practice Address - Phone:501-687-0826
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-14
Last Update Date:2019-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2663152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR4T077C877Medicare PIN