Provider Demographics
NPI:1669591129
Name:FOSTER, RICHARD (OD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:FOSTER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:DR
Other - First Name:RICHARD
Other - Middle Name:
Other - Last Name:FOSTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:15 VIXEN TRL
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72076-2677
Mailing Address - Country:US
Mailing Address - Phone:501-982-3811
Mailing Address - Fax:501-982-1864
Practice Address - Street 1:2000 JOHN HARDEN DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72076-2730
Practice Address - Country:US
Practice Address - Phone:501-982-3811
Practice Address - Fax:501-985-1434
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROP1100197152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management