| Vista Health Physican Group | |
|
4253 N Crossover Rd Fayetteville AR 72703-4593 | |
| (479) 521-5731 | |
| (479) 521-4926 |
| Full Name | Vista Health Physican Group |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 4253 N Crossover Rd, Fayetteville, Arkansas |
| Authorized Official Name and Position | Brian P. Farley (VICE PRESIDENT & SECRETARY) |
| Authorized Official Contact | 6158616000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vista Health Physican Group 4253 N Crossover Rd Fayetteville AR 72703-4593 Ph: (479) 521-5731 | Vista Health Physican Group 4253 N Crossover Rd Fayetteville AR 72703-4593 Ph: (479) 521-5731 |
| NPI Number | 1114040888 |
|---|---|
| Provider Enumeration Date | 04/09/2007 |
| Last Update Date | 08/27/2023 |
| Certification Date | 08/27/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114040888 | NPI | - | NPPES |
| 162558002 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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