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3425 N Futrall Dr Ste 103 Fayetteville AR 72703-4820 | |
| (479) 713-8350 | |
| (479) 713-8375 |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 3425 N Futrall Dr Ste 103, Fayetteville, Arkansas |
| Authorized Official Name and Position | Amanda D George (VICE CHANCELLOR-CHIEF FINANCIAL OFF) |
| Authorized Official Contact | 5016865670 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 251420 Little Rock AR 72225-1420 Ph: (501) 686-8000 | 3425 N Futrall Dr Ste 103 Fayetteville AR 72703-4820 Ph: (479) 713-8350 |
| NPI Number | 1720217599 |
|---|---|
| Provider Enumeration Date | 07/14/2009 |
| Last Update Date | 12/07/2022 |
| Certification Date | 12/07/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720217599 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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