Individual
RANDALL BENJAMIN OATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4220 N.CROSSOVERRD, FAYETTEVILLE, AR 70703
(479) 251-1552
(479) 251-8956
Mailing address
4220 N.CROSSOVERRD, FAYETTEVILLE, AR 70703
(479) 251-1552
(479) 251-8956
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C-5922
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C-5922
ARK STATE MEDICAL BOARD
AR
Enumeration date
03/06/2007
Last updated
07/08/2007
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