Organization
NORTHWEST ARKANSAS IMMUNIZATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIMBERLY L CADLE MD (AUTHORIZED OFFICIA-OWNER)
(479) 273-5437
Entity
Organization
Contact information
Practice address
2719 SE I ST, BENTONVILLE, AR 72712-3996
(479) 273-5437
(479) 273-9932
Mailing address
PO BOX 9178, RUSSELLVILLE, AR 72811-9178
(479) 968-4273
(479) 968-1363
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
11/01/2010
Last updated
11/09/2010
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