Organization
JONATHAN F. SHAVER, O.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN F SHAVER O.D. (OPTOMETRIST)
(479) 871-0921
Entity
Organization
Contact information
Practice address
110 SCHOOL ST, PRAIRIE GROVE, AR 72753-2655
(479) 871-0921
Mailing address
718 N 46TH AVE, FAYETTEVILLE, AR 72704-7621
(479) 871-0921
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2549
AR
Other
Enumeration date
10/02/2013
Last updated
10/02/2013
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