# WASHINGTON REGIONAL MEDICAL SYSTEM

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Washington Regional Urgent Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700297033
- **Authorized official:** MR. JAMES SHACKELFORD (CEO)
- **Authorized official phone:** (479) 463-6004

## Contact information

- **Practice address:** 3 E. APPLEBY ROAD, SUITE 101, FAYETTEVILLE, AR 72703
- **Practice address phone:** (479) 404-1010
- **Practice address fax:** (479) 404-1011
- **Mailing address:** PO BOX 550, LOWELL, AR 72745-0550
- **Mailing address phone:** (479) 463-7775
- **Mailing address fax:** (479) 463-7187

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/08/2014
- **Last updated:** 01/24/2018