Organization
ROUSE FAMILY MEDICAL CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA WESTACOTT (BILLING MANAGER)
(479) 443-0500
Entity
Organization
Contact information
Practice address
1306 S PLEASANT ST, SPRINGDALE, AR 72764-6223
(479) 443-0500
(833) 449-3362
Mailing address
1306 S PLEASANT ST, SPRINGDALE, AR 72764-6223
(479) 443-0500
(833) 449-3362
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C4405
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
012083557
UHC
AR
05
—
106345001
—
AR
01
—
122530000
QUALCHOICE QC
AR
01
—
126089002
MEDICAID GROUP
AR
Enumeration date
03/12/2007
Last updated
02/26/2026
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