1316026891 NPI number — DAN T SPEIR OD PA

Table of content: (NPI 1316026891)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316026891 NPI number — DAN T SPEIR OD PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DAN T SPEIR OD PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1316026891
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 59
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HARDY
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
72542
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
870-994-2775
Provider Business Mailing Address Fax Number:
870-994-3032

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1238 HWY 62 412
Provider Second Line Business Practice Location Address:
STE B
Provider Business Practice Location Address City Name:
HARDY
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72542
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
870-994-2775
Provider Business Practice Location Address Fax Number:
870-994-3032
Provider Enumeration Date:
11/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SPEIR
Authorized Official First Name:
DANNY
Authorized Official Middle Name:
THOMAS
Authorized Official Title or Position:
OPTOMETRIST OWNER
Authorized Official Telephone Number:
870-994-2775

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  2181 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 15370000040 . This is a "QUAL CHOICE" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com