Individual
DR. HESSEL KOOISTRA III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10971 ROCKY CREEK RD, FAYETTEVILLE, AR 72701-0614
(479) 841-2736
Mailing address
10975 ROCKY CREEK RD, FAYETTEVILLE, AR 72701-0614
(479) 841-2736
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
E-2570
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
P000516J3
—
TX
Enumeration date
04/12/2013
Last updated
04/12/2013
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