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Individual

CYGNET A BISE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1001 TOWSON AVE, FORT SMITH, AR 72901-4921
(479) 478-8555
(479) 478-8555
Mailing address
PO BOX 3363, FORT SMITH, AR 72913-3363
(479) 478-8555
(479) 478-8568

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
R4158
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100174420B
OK
05
149716002
AR
01
250014112
RAIL ROAD MEDICARE
AR
01
4102586
AETNA
AR
Enumeration date
05/23/2005
Last updated
11/11/2010
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