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Individual

DR. MATTHEW C RENNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
6210 MASSARD RD STE 103, FORT SMITH, AR 72916-5042
(479) 353-5833
(479) 358-1435
Mailing address
6210 MASSARD RD STE 103, FORT SMITH, AR 72916-5042
(479) 353-5833
(479) 358-1435

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2524
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
146786722
AR
05
1467867A
AR
01
410048511
RR MEDICARE
Enumeration date
07/19/2006
Last updated
04/10/2026
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