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Organization

FAYETTEVILLE PLASTIC SURGERY CLINIC

Active
Other names
Plastic Surgery Clinic of Northwest Arkansas
Organization subpart
No

Provider details

NPI number
Authorized official
MS. C RENEE SANDLIN (ADMINISTRATOR)
(479) 443-7771
Entity
Organization

Contact information

Practice address
1794 E JOYCE BLVD, SUITE 1, FAYETTEVILLE, AR 72703-5256
(479) 443-7771
(479) 443-7790
Mailing address
1794 E JOYCE BLVD, SUITE 1, FAYETTEVILLE, AR 72703-5256
(479) 443-7771
(479) 443-7790

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
R3739
AR

Other

Enumeration date
10/18/2007
Last updated
10/25/2007
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