Organization
MATTHEW J. CROUCH, MD, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAVONNA M LATTA (BUSINESS MANAGER)
47944425437
Entity
Organization
Contact information
Practice address
1 W SUNBRIDGE DR, FAYETTEVILLE, AR 72703-1825
(479) 442-5437
(479) 521-5996
Mailing address
1 W SUNBRIDGE DR, FAYETTEVILLE, AR 72703-1825
(479) 442-5437
(479) 521-5996
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
E4759
AR
Other
Enumeration date
03/18/2008
Last updated
07/30/2008
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