Provider Demographics
NPI:1790742039
Name:SLOAN EYE CLINIC
Entity Type:Organization
Organization Name:SLOAN EYE CLINIC
Other - Org Name:SLOAN EYE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:LEN
Authorized Official - Last Name:LOWERY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:870-793-4040
Mailing Address - Street 1:10 HOSPITAL CIR
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72501-7310
Mailing Address - Country:US
Mailing Address - Phone:870-793-4040
Mailing Address - Fax:870-793-5649
Practice Address - Street 1:10 HOSPITAL CIR
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-7310
Practice Address - Country:US
Practice Address - Phone:870-793-4040
Practice Address - Fax:870-793-5649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-28
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR136332002Medicaid
AR5C797OtherBLUE CROSS-BLUE SHIELD
AR5C797OtherBLUE CROSS-BLUE SHIELD