Organization
DONNA BEALLIS D.O. P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DONNA B BEALLIS D.O. (OWNER)
(479) 806-0647
Entity
Organization
Contact information
Practice address
153 E MONTE PAINTER DR, FAYETTEVILLE, AR 72703-4002
(479) 444-2200
(479) 444-2390
Mailing address
PO BOX 11134, FORT SMITH, AR 72917-1134
(479) 285-5497
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
E-5626
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200199440A
—
OK
Enumeration date
11/16/2009
Last updated
10/05/2021
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