| Arkansas Phs Pa | |
|
609 Sw 8th Street Suite 600 Bentonville AR 72712-8913 | |
| (901) 261-4848 | |
| (901) 261-4849 |
| Full Name | Arkansas Phs Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 609 Sw 8th Street, Bentonville, Arkansas |
| Authorized Official Name and Position | Nicole Howard (CFO) |
| Authorized Official Contact | 3379919276 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Arkansas Phs Pa 1509 Dulles Drive Lafayette LA 70506 Ph: (337) 991-9276 | Arkansas Phs Pa 609 Sw 8th Street Suite 600 Bentonville AR 72712-8913 Ph: (901) 261-4848 |
| NPI Number | 1194956516 |
|---|---|
| Provider Enumeration Date | 08/03/2009 |
| Last Update Date | 07/02/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194956516 | NPI | - | NPPES |
| 190440762 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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