Organization
BENTONVILLE ANESTHESIA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF HAYS (BUSINESS MANAGER)
(847) 615-2200
Entity
Organization
Contact information
Practice address
3000 MEDICAL CENTER PKWY, BENTONVILLE, AR 72712-3217
(479) 563-4368
(847) 615-2858
Mailing address
PO BOX 756, LOWELL, AR 72745-0756
(847) 615-2200
(847) 615-2858
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5F200
BCBS OF ARKANSAS
AR
Enumeration date
07/05/2006
Last updated
10/29/2007
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