# MATTHEW J. CROUCH, MD, PLLC

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

## Provider details

- **NPI number:** 1316118326
- **Authorized official:** LAVONNA M LATTA (BUSINESS MANAGER)
- **Authorized official phone:** 47944425437

## Contact information

- **Practice address:** 1 W SUNBRIDGE DR, FAYETTEVILLE, AR 72703-1825
- **Practice address phone:** (479) 442-5437
- **Practice address fax:** (479) 521-5996
- **Mailing address:** 1 W SUNBRIDGE DR, FAYETTEVILLE, AR 72703-1825
- **Mailing address phone:** (479) 442-5437
- **Mailing address fax:** (479) 521-5996

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084P0804X | Child & Adolescent Psychiatry Physician | E4759 | AR | Yes |

## Other

- **Enumeration date:** 03/18/2008
- **Last updated:** 07/30/2008