Provider Demographics
NPI:1942497722
Name:WEBB EYE CARE PA
Entity Type:Organization
Organization Name:WEBB EYE CARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:JASON
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:479-632-3939
Mailing Address - Street 1:909 HIGHWAY 71 N
Mailing Address - Street 2:
Mailing Address - City:ALMA
Mailing Address - State:AR
Mailing Address - Zip Code:72921-5160
Mailing Address - Country:US
Mailing Address - Phone:479-632-3939
Mailing Address - Fax:479-632-3938
Practice Address - Street 1:909 HIGHWAY 71 N
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:AR
Practice Address - Zip Code:72921-5160
Practice Address - Country:US
Practice Address - Phone:479-632-3939
Practice Address - Fax:479-632-3938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-26
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2511152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR145466722Medicaid
AR5GA37Medicare PIN
AR49793Medicare UPIN
AR145466722Medicaid