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Contact Information

SUSAN S DEBLACK, OD
4150 TYLER ST.
SUITE 1
CONWAY, AR72034
 Phone: 501-329-7878
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for SUSAN S DEBLACK · (Female)

NPI Number 1245224179
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 09/07/2005
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • AR License # 2410
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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