Individual
BENJAMIN D BOATWRIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BS, QBHP
Contact information
Practice address
2153 E JOYCE BLVD STE 201, FAYETTEVILLE, AR 72703-5285
(479) 575-9471
(479) 857-9392
Mailing address
2153 E JOYCE BLVD STE 201, FAYETTEVILLE, AR 72703-5285
(479) 575-9471
(479) 857-9392
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
239578795
—
AR
Enumeration date
01/06/2020
Last updated
06/30/2020
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