NPI 1124684923 · live from the CMS NPI Registry
Ivory A. Kinslow, Mdpa
Optometrist in Magnolia, AR. National Provider Identifier 1124684923, active.
NPI record
| NPI | 1124684923 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Optometrist 152W00000X |
| Practice location | 220 N Pine, Magnolia, AR 71753 |
| Practice phone | 870-234-4444 |
| Mailing address | Po Box 11090, El Dorado, AR 71730 |
| Enumerated | May 16, 2019 |
| Last updated | May 16, 2019 |
| Authorized official | Sharon Winn, Ceo |
| Other names | Ivory A. Kinslow, Mdpa Mag |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Ophthalmology | 207W00000X | — |
| Optometrist primary | 152W00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.