NPI 1245224179

Susan S Deblack, OD

Practitioner Optometrist Conway, AR

Practice location

Address: 4150 Tyler St. Suite 1, Conway, AR 72034
Phone: (501) 329-7878

Registered specialties

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X Licence 2410 (AR)

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Registry record

NPI: 1245224179
Entity type: Individual
Sex (as registered): Female
NPI issued: 7 Sep 2005
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.