Organization
PHYSICIANS' SURGERY CENTER OF FAYETTEVILLE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUSS GREENE R.N. (ADMINISTRATOR)
(479) 527-0050
Entity
Organization
Contact information
Practice address
3733 N BUSINESS DR, SUITE #101, FAYETTEVILLE, AR 72703-5203
(479) 527-0050
(479) 527-0030
Mailing address
3733 N BUSINESS DR, SUITE #101, FAYETTEVILLE, AR 72703-5203
(479) 527-0050
(479) 527-0030
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
AR4272
AR
Other
Enumeration date
10/07/2005
Last updated
04/16/2009
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