| Lafferty Family Care | |
|
1706 Se Walton Blvd Suite 4 Bentonville AR 72712-3200 | |
| (479) 464-0400 | |
| (479) 268-5688 |
| Full Name | Lafferty Family Care |
|---|---|
| Speciality | Family Medicine |
| Location | 1706 Se Walton Blvd, Bentonville, Arkansas |
| Authorized Official Name and Position | Warren Scott Lafferty (PHYSICIAN/OWNER) |
| Authorized Official Contact | 4794640400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lafferty Family Care 1706 Se Walton Blvd Suite 4 Bentonville AR 72712-3200 Ph: (479) 464-0400 | Lafferty Family Care 1706 Se Walton Blvd Suite 4 Bentonville AR 72712-3200 Ph: (479) 464-0400 |
| NPI Number | 1487904009 |
|---|---|
| Provider Enumeration Date | 09/11/2012 |
| Last Update Date | 10/31/2014 |
| Medicare PECOS PAC ID | 9335565134 |
|---|---|
| Medicare Enrollment ID | O20200811001971 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487904009 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Warren S Lafferty |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639118391 PECOS PAC ID: 2264471275 Enrollment ID: I20050428001114 |
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