Koontz, Bryan Scott

Koontz, Bryan Scott is an individual health care provider with primary practice located at 924 Main St , Conway AR 72032-5424. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Koontz, Bryan Scott can be contacted via phone (501) 327-4444.

Contact Information

Primary practice address
924 Main St Conway AR 72032-5424
Phone: (501) 327-4444
Fax: (501) 327-3962
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 2494 Arkansas

Profile Details

NPI number 1609850916
LBN Legal business name Koontz, Bryan Scott
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 30th, 2005
Last updated Jan 23rd, 2020 - about 6 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609850916 NPPES
Arkansas MEDICAID 137583722

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