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Organization
WASHINGTON REGIONAL MEDICAL SYSTEM
Active
Organization
WASHINGTON REGIONAL MEDICAL SYSTEM
Active
Other names
Washington Regional Family Clinic Fayetteville
Organization subpart
No
Provider details
NPI number
Authorized official
MARY JO ROTHROCK (DIRECTOR CLINIC ADMINISTRATION)
(479) 463-1390
Entity
Organization
Contact information
Practice address
3053 N COLLEGE AVENUE, FAYETTEVILLE, AR 72703
(479) 463-2000
(479) 442-4518
Mailing address
PO BOX 879, FAYETTEVILLE, AR 72702-0879
(479) 713-7115
(479) 713-7186
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
05/19/2006
Last updated
03/25/2008
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