Organization
NORTHWEST ARKANSAS PRIMARY CARE PHYSICIANS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRET RAYMOND (DIRECTOR OF SALES/OPERATIONS)
(479) 845-0880
Entity
Organization
Contact information
Practice address
3400 SE MACY RD, STE 18, BENTONVILLE, AR 72712-7841
(479) 845-0880
Mailing address
3400 SE MACY RD, STE 18, BENTONVILLE, AR 72712-7841
(479) 845-0880
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E1802
SUBMITTER NUMBER
—
Enumeration date
08/14/2006
Last updated
08/22/2020
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