Provider Demographics
NPI:1104478296
Name:BUTTON, JENNIFER A (OD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:A
Last Name:BUTTON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:527 N 6TH ST
Mailing Address - Street 2:
Mailing Address - City:BLYTHEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72315-2407
Mailing Address - Country:US
Mailing Address - Phone:870-762-2297
Mailing Address - Fax:870-763-2552
Practice Address - Street 1:527 N 6TH ST
Practice Address - Street 2:
Practice Address - City:BLYTHEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72315-2407
Practice Address - Country:US
Practice Address - Phone:870-762-2297
Practice Address - Fax:870-763-2552
Is Sole Proprietor?:No
Enumeration Date:2019-07-10
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2106152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist