Organization
HUDEFI MENTAL HEALTH SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FAYZ A HUDEFI MD (OWNER)
(479) 353-0901
Entity
Organization
Contact information
Practice address
2010 CHESTNUT ST, VAN BUREN, AR 72956-5321
(479) 782-5500
Mailing address
PO BOX 10674, FORT SMITH, AR 72917-0674
(479) 782-5500
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
E4773
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06070018900
QUALCHOICE
AR
01
—
5N608
BCBS
AR
Enumeration date
04/22/2010
Last updated
08/31/2011
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