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1125 N College Ave Fayetteville AR 72703-1908 | |
(479) 521-8260 | |
(479) 443-3903 |
Full Name | |
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Speciality | Family Medicine |
Location | 1125 N College Ave, Fayetteville, Arkansas |
Authorized Official Name and Position | Amanda 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 |
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1125 N College Ave Fayetteville AR 72703-1908 Ph: (479) 521-8260 | 1125 N College Ave Fayetteville AR 72703-1908 Ph: (479) 521-8260 |
NPI Number | 1457320780 |
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Provider Enumeration Date | 03/17/2006 |
Last Update Date | 11/19/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1457320780 | NPI | - | NPPES |
770033568 | Other | AR | AR BREAST CARE |
56997 | Other | AR | AR BCBS |
305248002 | Medicaid | AR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
K E Management Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1420 E Augustine Ln Ste 7, Fayetteville, AR 72703 Phone: 479-200-9812 Fax: 866-243-7203 | |
Arcare Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1792 E Joyce Blvd, Fayetteville, AR 72703 Phone: 501-500-5001 Fax: 501-500-5001 | |