Individual
DR. JESSICA HAILEY STATZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
609 W MAPLE AVE, SPRINGDALE, AR 72764-5335
(479) 751-3722
(479) 751-1099
Mailing address
601 W MAPLE AVE STE 503, SPRINGDALE, AR 72764-5376
(479) 751-3722
(479) 751-1099
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
DR.0043776
CO
207L00000X
Anesthesiology Physician
Primary
E-13712
AR
207Q00000X
Family Medicine Physician
43776
CO
207Q00000X
Family Medicine Physician
52344-21
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000165743
—
CO
Enumeration date
01/26/2007
Last updated
03/06/2023
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