MR. JOHN BRADLEY WITHERSPOON (NPI# 1336131887) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336131887 |
| Entity Type | Individual |
| Full Name | MR. JOHN BRADLEY WITHERSPOON |
| Credential | O.D. |
| Practice Address |
1155 Hwy 65 North Conway AR 72032 |
| Practice Telephone | 5013289500 |
| Practice Fax Number | 5013285148 |
| Mailing Telephone | 5013289500 |
| Mailing Fax Number | 5013285148 |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2010-08-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 2272 | AR | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 106399722 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518057165 | John M. Witherspoon | Internal Medicine | 1250 E Marshall St, Richmond, VA 23298-5051 | 2006-10-13 |
| 1134199664 | John D Witherspoon | Otolaryngology | 2001 Hayes St, Nashville, TN 37203-2324 | 2006-01-26 |
| Street Address |
1155 HWY 65 NORTH |
| City | CONWAY |
| State | AR |
| Zip Code | 72032 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548869977 | Juliana Oguh | Pharmacist | 1155 Hwy 65 North, Conway, AR 72032-7203 | 2020-10-16 |
| 1447549373 | Conway Eye Center | Optometrist | 1155 Hwy 65 North, Conway, AR 72032 | 2011-03-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730789843 | Amelia S Lasater | Pharmacist | 1155 Hwy 65n, Conway, AR 72032 | 2020-10-28 |
| 1619584604 | Danyelle Durocher | Occupational Therapist | 1301 North Museum Rd, Conway, AR 72032 | 2020-09-24 |
| 1780222174 | Eric Herman Boxnick | Pharmacist | 101 West Oak Street, Conway, AR 72032 | 2019-12-16 |
| 1932746070 | Habilitation Center, LLC | Psychiatric Residential Treatment Facility | 161 Skunk Hollow Road, Conway, AR 72032 | 2019-12-09 |
| 1679051668 | Mary Elizabeth Black | Nurse Practitioner | 222 Dave Ward Drive, Conway, AR 72032 | 2018-08-01 |
| 1275035602 | Conway Dental Center Pllc | Dentist | 1600 E. Oak Street Suite B, Conway, AR 72032 | 2018-03-01 |
| 1750821625 | Luke Osborne | Physical Therapy Assistant | 1 Thomas Ln, Conway, AR 72032 | 2017-02-27 |
| 1639620099 | Sam's West, Inc. | Technician/Technologist | 1250 South Amity Rd, Conway, AR 72032 | 2016-10-20 |
| 1922559343 | Sam's West, Inc. | Durable Medical Equipment & Medical Supplies | 1250 Sourth Amity Rd, Conway, AR 72032 | 2016-10-20 |
| 1639629108 | Posture Store | Durable Medical Equipment & Medical Supplies | 3900 Dave Ward Dr., Suite 1900-130, Conway, AR 72032 | 2016-10-09 |
| Find all providers in zip 72032 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609235829 | Sthomasinc | Optometrist | 1315 Highway 501 Business, Suite A, Conway, SC 29526-9549 | 2016-02-16 |
| 1447615208 | Abl Enterprises, LLC | Optometrist | 113 Citadel Drive, Conway, SC 29526 | 2015-12-22 |
| 1548692668 | Sarah Davis | Optometrist | 4150 Tyler St, Suite 1, Conway, AR 72034-8513 | 2013-07-31 |
| 1700224227 | Barnes Cox Pa | Optometrist | 3900 Dave Ward Drive, Conway, AR 72034 | 2013-06-06 |
| 1770862716 | Realeyes Eye Care, LLC | Optometrist | 47b Poliquin Dr, Conway, NH 03818-1380 | 2011-08-09 |
| 1972735546 | Leigh E. Cox, O.d., P.a. | Optometrist | 821 Hogan Lane, Suite 500, Conway, AR 72034 | 2009-08-17 |
| 1043449713 | Rebecca M King | Optometrist | 201 Skyline Dr Ste 37, Conway, AR 72032-3500 | 2009-07-02 |
| 1063568038 | James Warren Stuckey | Optometrist | 1155 Highway 65 North, Conway, AR 72032-3500 | 2007-01-25 |
| 1053486803 | Deblack Eye Care Center, P.a. | Optometrist | 4150 Tyler Street, Suite 1, Conway, AR 72034 | 2006-11-21 |
| 1013087139 | Leigh E Cox | Optometrist | 821 Hogan Ln, Suite 500, Conway, AR 72034-7974 | 2006-11-08 |
| Find all providers in CONWAY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.