Individual
ROBERT RUSSELL ORGAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
3316 W GROVE DR STE 1, FAYETTEVILLE, AR 72704-5003
(479) 521-2020
(888) 533-6054
Mailing address
PO BOX 9628, FAYETTEVILLE, AR 72703-0028
(479) 521-2020
(888) 533-6054
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2412
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
126253722
—
AR
Enumeration date
07/21/2006
Last updated
05/11/2019
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