Organization
FAYETTEVILLE ARKANSAS HOSPITAL COMPANY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER L JACKSON (SR. DIRECTOR PROVIDER ENROLLMENT)
(615) 465-3334
Entity
Organization
Contact information
Practice address
3873 N PARKVIEW DR, FAYETTEVILLE, AR 72703-6286
(479) 571-7070
(479) 571-7090
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022
(615) 778-8075
(615) 628-6877
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
03/18/2016
Last updated
03/05/2022
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