# WASHINGTON REGIONAL MEDICAL SYSTEM

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Washington Regional Internal Medicine Associates
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770846826
- **Authorized official:** MR. WILLIAM L BRADLEY (CEO)
- **Authorized official phone:** (479) 463-6003

## Contact information

- **Practice address:** 688 E MILLSAP RD, FAYETTEVILLE, AR 72703-4095
- **Practice address phone:** (479) 463-3070
- **Practice address fax:** (479) 463-3077
- **Mailing address:** 688 E MILLSAP RD, FAYETTEVILLE, AR 72703-4095
- **Mailing address phone:** (479) 463-3070
- **Mailing address fax:** (479) 463-3077

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | E4712 | AR | Yes |

## Other

- **Enumeration date:** 06/22/2012
- **Last updated:** 06/22/2012