Ford, Shane

Ford, Shane is an individual health care provider with primary practice located at 3005 Fountain Drive , Conway AR 72034-3684. He recently has 4 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Low Vision Rehabilitation, Eye and Vision Services Providers / Pediatrics. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Ford, Shane can be contacted via phone (501) 329-9851.

Contact Information

Primary practice address
3005 Fountain Drive Conway AR 72034-3684
Phone: (501) 329-9851
Fax: (501) 329-9854
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 2505 Arkansas
Eye and Vision Services Providers / Corneal and Contact Management 152WC0802X 2505 Arkansas
Eye and Vision Services Providers / Low Vision Rehabilitation 152WL0500X 2505 Arkansas
Eye and Vision Services Providers / Pediatrics 152WP0200X 2505 Arkansas

Profile Details

NPI number 1497714075
LBN Legal business name Ford, Shane
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 21st, 2006
Last updated Oct 18th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1497714075 NPPES
Arkansas MEDICAID 140746722

Popular Providers