Organization
FAYETTEVILLE PSYCHIATRY, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADRIANA STACEY MD (CO-MANAGER)
(479) 966-6993
Entity
Organization
Contact information
Practice address
205 N COLLEGE AVE, FAYETTEVILLE, AR 72701-4238
(479) 966-6993
Mailing address
4641 E BRIDGEWATER LN, FAYETTEVILLE, AR 72703-4670
(479) 966-6993
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
08/30/2019
Last updated
08/30/2019
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