Provider Demographics
NPI:1699747568
Name:STILES, STEVEN B (OD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:B
Last Name:STILES
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 S WALDRON RD
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72903-3736
Mailing Address - Country:US
Mailing Address - Phone:479-452-2020
Mailing Address - Fax:479-452-4759
Practice Address - Street 1:2401 S WALDRON RD
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-3736
Practice Address - Country:US
Practice Address - Phone:479-452-2020
Practice Address - Fax:479-452-4759
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2018-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2253152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR105798722Medicaid
AR49372OtherBCBS
ART20305Medicare UPIN
AR49372Medicare ID - Type Unspecified