Organization
ANCILLARY INNOVATIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. REGINA E THURMAN MD (CEO)
(479) 301-2565
Entity
Organization
Contact information
Practice address
1792 E JOYCE BLVD STE 3, FAYETTEVILLE, AR 72703-5255
(479) 301-2565
(479) 301-2717
Mailing address
1792 E JOYCE BLVD STE 3, FAYETTEVILLE, AR 72703-5255
(479) 301-2565
(479) 301-2717
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
AR
Other
Enumeration date
04/16/2015
Last updated
04/16/2015
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