Provider Demographics
NPI:1427050111
Name:WEBB, ANNETTE GAIL (OD)
Entity type:Individual
Prefix:DR
First Name:ANNETTE
Middle Name:GAIL
Last Name:WEBB
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:ANNETTE
Other - Middle Name:G
Other - Last Name:CAMPBELL-WEBB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:250 ADAM BROWN RD UNIT A
Mailing Address - Street 2:
Mailing Address - City:PEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:71964-9519
Mailing Address - Country:US
Mailing Address - Phone:501-318-2020
Mailing Address - Fax:501-767-5450
Practice Address - Street 1:250 ADAM BROWN RD UNIT A
Practice Address - Street 2:
Practice Address - City:PEARCY
Practice Address - State:AR
Practice Address - Zip Code:71964-9519
Practice Address - Country:US
Practice Address - Phone:501-318-2020
Practice Address - Fax:501-767-5450
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2499152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR139673722Medicaid
ARU62694Medicare UPIN
AR139673722Medicaid