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Organization

WASHINGTON REGIONAL MEDICAL SYSTEM

Active
Other names
Washington Regional Family Clinic Fayetteville
Organization subpart
No

Provider details

NPI number
Authorized official
MARY JO ROTHROCK (DIRECTOR CLINIC ADMINISTRATION)
(479) 463-1390
Entity
Organization

Contact information

Practice address
3053 N COLLEGE AVENUE, FAYETTEVILLE, AR 72703
(479) 463-2000
(479) 442-4518
Mailing address
PO BOX 879, FAYETTEVILLE, AR 72702-0879
(479) 713-7115
(479) 713-7186

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Enumeration date
05/19/2006
Last updated
03/25/2008
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