| Crossroads Telemedicine Pllc | |
|
3790 N Bellafont Blvd Ste 1 Fayetteville AR 72703-5481 | |
| (479) 439-0777 | |
| (888) 815-1613 |
| Full Name | Crossroads Telemedicine Pllc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 3790 N Bellafont Blvd Ste 1, Fayetteville, Arkansas |
| Authorized Official Name and Position | Thomas B De Miranda (OWNER) |
| Authorized Official Contact | 4792851255 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Crossroads Telemedicine Pllc 3790 N Bellafont Blvd Ste 1 Fayetteville AR 72703-5481 Ph: (479) 439-0777 | Crossroads Telemedicine Pllc 3790 N Bellafont Blvd Ste 1 Fayetteville AR 72703-5481 Ph: (479) 439-0777 |
| NPI Number | 1285371021 |
|---|---|
| Provider Enumeration Date | 05/13/2022 |
| Last Update Date | 05/13/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285371021 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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