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Individual

DANIEL J HENNESSEY III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
4200 N. RODNEY PARHAM ROAD, SUITE 101, LITTLE ROCK, AR 72212
(501) 224-5658
(501) 687-0801
Mailing address
201 EXECUTIVE CT, SUITE A, LITTLE ROCK, AR 72205-4536
(501) 224-5658
(501) 224-8114

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2322
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
110756722
AR
01
48867
MEDICARE ID-TYPE UNSPECIFIED
AR
Enumeration date
12/13/2005
Last updated
10/15/2019
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