Provider Demographics
NPI:1548692668
Name:DAVIS, SARAH (OD)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4150 TYLER STREET
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-7110
Mailing Address - Country:US
Mailing Address - Phone:501-329-7878
Mailing Address - Fax:501-329-7881
Practice Address - Street 1:4150 TYLER ST
Practice Address - Street 2:SUITE 1
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-8513
Practice Address - Country:US
Practice Address - Phone:501-329-7878
Practice Address - Fax:501-329-7881
Is Sole Proprietor?:No
Enumeration Date:2013-07-31
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2686152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist