Organization
IVORY A. KINSLOW, MDPA
Active
Parent organization
IVORY A. KINSLOW, MDPA
Other names
Ivory A. Kinslow, MDPA MAG
Organization subpart
Yes
Provider details
NPI number
Legal business name
IVORY A. KINSLOW, MDPA
Authorized official
SHARON L WINN (CEO)
(573) 718-4808
Entity
Organization
Contact information
Practice address
220 N PINE, MAGNOLIA, AR 71753-2905
(870) 234-4444
Mailing address
PO BOX 11090, EL DORADO, AR 71730-0031
(870) 862-2340
(870) 863-4951
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
207W00000X
Ophthalmology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2124
OPTOMETRIST LICENSE
AR
Enumeration date
05/16/2019
Last updated
05/16/2019
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