Provider Demographics
NPI:1902083868
Name:DAVID P SCHWARZ O D P C
Entity Type:Organization
Organization Name:DAVID P SCHWARZ O D P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:S
Authorized Official - Last Name:SCHNADELBACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-798-3164
Mailing Address - Street 1:PO BOX 444
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:AR
Mailing Address - Zip Code:72654-0444
Mailing Address - Country:US
Mailing Address - Phone:870-701-5119
Mailing Address - Fax:870-424-3588
Practice Address - Street 1:105 SAWGRASS PT
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:AR
Practice Address - Zip Code:72601
Practice Address - Country:US
Practice Address - Phone:870-741-1910
Practice Address - Fax:870-741-6331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-23
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR232040722Medicaid
MS00880121Medicaid
4386270001Medicare NSC