| Primary Care Collective, PLLC | |
|
11300 Roberts Blvd Fort Smith AR 72916-6027 | |
| (479) 242-5910 | |
| (479) 668-0169 |
| Full Name | Primary Care Collective, PLLC |
|---|---|
| Speciality | Family Medicine |
| Location | 11300 Roberts Blvd, Fort Smith, Arkansas |
| Authorized Official Name and Position | Delli Rae Tyler (PHYSICIAN) |
| Authorized Official Contact | 4798830917 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Primary Care Collective, PLLC 11300 Roberts Blvd Fort Smith AR 72916-6027 Ph: (479) 242-5910 | Primary Care Collective, PLLC 11300 Roberts Blvd Fort Smith AR 72916-6027 Ph: (479) 242-5910 |
| NPI Number | 1013871714 |
|---|---|
| Provider Enumeration Date | 12/16/2025 |
| Last Update Date | 03/11/2026 |
| Certification Date | 03/11/2026 |
| Medicare PECOS PAC ID | 7214414333 |
|---|---|
| Medicare Enrollment ID | O20260121000076 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013871714 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| Provider Name | Delli Rae Tyler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093455263 PECOS PAC ID: 8123505245 Enrollment ID: I20260121000093 |
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