Provider Demographics
NPI:1487095543
Name:JOSEPH B SUGG, O.D., P.A.
Entity type:Organization
Organization Name:JOSEPH B SUGG, O.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:B
Authorized Official - Last Name:SUGG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:501-362-8191
Mailing Address - Street 1:PO BOX 790
Mailing Address - Street 2:
Mailing Address - City:HEBER SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:72543-0790
Mailing Address - Country:US
Mailing Address - Phone:501-362-8191
Mailing Address - Fax:501-362-3096
Practice Address - Street 1:111 E FRONT ST
Practice Address - Street 2:
Practice Address - City:HEBER SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:72543-2655
Practice Address - Country:US
Practice Address - Phone:501-362-8191
Practice Address - Fax:501-362-3096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-17
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2629152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR180121722Medicaid
AR180121722Medicaid
AR7031350001Medicare NSC