Organization
UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES
Active
Other names
AHEC Fayetteville Pediatric Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. B J ROBERTS (CHIEF FINANCIAL OFFICER)
(479) 521-8269
Entity
Organization
Contact information
Practice address
1125 N COLLEGE AVE, FAYETTEVILLE, AR 72703-1908
(479) 521-8269
(479) 443-3903
Mailing address
1125 N COLLEGE AVE, FAYETTEVILLE, AR 72703-1908
(479) 521-8269
(479) 443-3903
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
170583069
—
AR
01
—
56997
AR BCBS
AR
01
—
770033568
AR BREAST CARE
AR
Enumeration date
07/02/2008
Last updated
01/28/2010
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