Individual
DR. JONATHAN F SHAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
594 E MILLSAP, FAYETTEVILLE, AR 72703-1345
(479) 442-2020
(479) 521-3988
Mailing address
594 E MILLSAP, FAYETTEVILLE, AR 72703-2801
(479) 442-2020
(479) 521-3988
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2549
AR
152W00000X
Optometrist
558
NM
152WC0802X
Corneal and Contact Management Optometrist
2549
AR
152WP0200X
Pediatric Optometrist
2549
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
157556722
—
AR
Enumeration date
01/11/2006
Last updated
09/11/2012
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