Provider Demographics
NPI:1396947669
Name:WILLIAM LAWRENCE YOOS, O.D.,P.A.
Entity type:Organization
Organization Name:WILLIAM LAWRENCE YOOS, O.D.,P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:YOOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-876-2020
Mailing Address - Street 1:2692 BELLA VISTA WAY
Mailing Address - Street 2:
Mailing Address - City:BELLA VISTA
Mailing Address - State:AR
Mailing Address - Zip Code:72714-3704
Mailing Address - Country:US
Mailing Address - Phone:479-876-2020
Mailing Address - Fax:479-876-2508
Practice Address - Street 1:2692 BELLA VISTA WAY
Practice Address - Street 2:
Practice Address - City:BELLA VISTA
Practice Address - State:AR
Practice Address - Zip Code:72714-3704
Practice Address - Country:US
Practice Address - Phone:479-876-2020
Practice Address - Fax:479-876-2508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROP1100235152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR122347722Medicaid
AR135801722Medicaid
ARU36969Medicare UPIN
AR135801722Medicaid
AR48576Medicare PIN