Individual
KENNETH N. HUBBARD JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
519 N WILLOW ST, HARRISON, AR 72601-3518
(870) 741-2787
Mailing address
PO BOX 2417, HARRISON, AR 72602-2417
(870) 741-2787
(870) 741-6714
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2093
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
48784
BLCR AND OTHER ID NUMBER
AR
01
—
5C405
CLINIC
AR
Enumeration date
05/24/2005
Last updated
11/21/2007
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