NPI 1194956516 · live from the CMS NPI Registry
Arkansas Phs PA
Family Medicine in Bentonville, AR. National Provider Identifier 1194956516, active.
NPI record
| NPI | 1194956516 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Family Medicine 207Q00000X |
| Practice location | 609 Sw 8th Street, Suite 600, Bentonville, AR 72712 |
| Practice phone | 901-261-4848 |
| Mailing address | 1509 Dulles Drive, Lafayette, LA 70506 |
| Enumerated | August 3, 2009 |
| Last updated | July 2, 2014 |
| Authorized official | Nicole Howard, Cfo |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Medicine primary | 207Q00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.