Individual
DR. FAYZ A HUDEFI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1001 TOWSON AVE FL 6, FORT SMITH, AR 72901-4921
(479) 441-5601
(479) 709-7423
Mailing address
11001 EXECUTIVE CENTER DR STE 200, LITTLE ROCK, AR 72211-4393
(479) 441-5601
(479) 521-6520
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
E-4773
AR
2084P0800X
Psychiatry Physician
E4773
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000181515
UNITED BEHAVIORAL HLTH
AR
01
—
06070018900
QUALCHOICE
AR
05
—
162087001
—
AR
05
—
200088300A
—
OK
01
—
5N608
BLUE CROSS
AR
Enumeration date
06/19/2006
Last updated
11/21/2022
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