Individual
DR. SHANE F LASTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
8500 S 36TH TER, FORT SMITH, AR 72908-8880
(479) 242-2020
(479) 242-1919
Mailing address
8500 S 36TH TER, FORT SMITH, AR 72908-8880
(479) 242-2020
(479) 242-1919
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
2135
OK
152W00000X
Optometrist
Primary
2427
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100764560A
—
OK
05
—
130679722
—
AR
Enumeration date
03/29/2006
Last updated
03/08/2021
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