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Individual

DR. JAMES A. S. HAISTEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
601 W MAPLE AVE, SUITE 703, SPRINGDALE, AR 72764-5379
(479) 750-2203
(479) 750-1193
Mailing address
18415 BLUE SPRINGS RD., FAYETTEVILLE, AR 72703
(479) 443-0102

Taxonomy

Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
R2395
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100161990A
OK
05
106402001
AR
01
122720000
QUAL CHOICE
AR
05
202372900
MO
01
R2395
AR STATE LICENSE
AR
Enumeration date
06/16/2006
Last updated
03/07/2023
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