Individual
PHILIP RAY FAUGHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
225 E JACKSON AVE, JONESBORO, AR 72401-3119
(870) 207-4100
Mailing address
5403 SHAD DR, JONESBORO, AR 72404-9419
(870) 919-0648
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
A006105
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A006105
—
AR
Enumeration date
02/03/2019
Last updated
02/03/2019
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