Organization
BENTONVILLE RADIOLOGY CONSULTANTS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID G JONG MD (MANAGING PARTNER)
(918) 392-1706
Entity
Organization
Contact information
Practice address
3000 MEDICAL CENTER PKWY, BENTONVILLE, AR 72712-3217
(479) 553-1000
(918) 664-6120
Mailing address
PO BOX 1029, FAYETTEVILLE, AR 72702-1029
(918) 392-1706
(918) 664-6120
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
156414002
—
AR
01
—
5F285
ARK. BCBS
AR
Enumeration date
02/23/2006
Last updated
05/24/2012
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