Organization
PRIMARY CARE 360
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KHALID RAYAZ MD (OWNER)
(501) 833-4001
Entity
Organization
Contact information
Practice address
100 SHADOW OAKS DR, SHERWOOD, AR 72120-6046
(501) 486-4045
Mailing address
100 SHADOW OAKS DR, SHERWOOD, AR 72120-6046
(501) 486-4045
(888) 213-5007
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E-4732
STATE LICENSE
AR
Enumeration date
09/18/2019
Last updated
10/21/2020
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