Individual
JACOB DUFOUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
101 DAWN DR, CENTERTON, AR 72719-9314
(479) 795-1411
(479) 795-1412
Mailing address
900 S 52ND ST STE 102, ROGERS, AR 72758-8640
(479) 657-6006
(479) 340-0285
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
2754
AR
152WP0200X
Pediatric Optometrist
2754
AR
152WV0400X
Vision Therapy Optometrist
Primary
AR2754
AR
152WV0400X
Vision Therapy Optometrist
OD 60559129
WA
Other
Enumeration date
08/27/2015
Last updated
05/13/2021
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