# DONNA BEALLIS D.O. P.A.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184951998
- **Authorized official:** MS. DONNA B BEALLIS D.O. (OWNER)
- **Authorized official phone:** (479) 806-0647

## Contact information

- **Practice address:** 153 E MONTE PAINTER DR, FAYETTEVILLE, AR 72703-4002
- **Practice address phone:** (479) 444-2200
- **Practice address fax:** (479) 444-2390
- **Mailing address:** PO BOX 11134, FORT SMITH, AR 72917-1134
- **Mailing address phone:** (479) 285-5497

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0505X | Adult Medicine Physician | E-5626 | AR | Yes |

## Other

- **Enumeration date:** 11/16/2009
- **Last updated:** 10/05/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200199440A | — | OK |