# VAMC

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

## Provider details

- **NPI number:** 1821104449
- **Authorized official:** MR. JON SCOTT KELLER PA (PHYSICIAN ASST)
- **Authorized official phone:** (479) 443-4301

## Contact information

- **Practice address:** 1100 N COLLEGE AVE, FAYETTEVILLE, AR 72703-1944
- **Practice address phone:** (479) 443-4301
- **Practice address fax:** (479) 587-5996
- **Mailing address:** 1621 N CHARLEE AVE, FAYETTEVILLE, AR 72703-3066
- **Mailing address phone:** (479) 444-7376
- **Mailing address fax:** (479) 587-5996

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 286500000X | Military Hospital | PA140 | AR | Yes |

## Other

- **Enumeration date:** 08/23/2006
- **Last updated:** 08/22/2020