| Northwest Arkansas Internal Medicine, Pllc | |
|
2805 Mid Cities Dr Suite 3 Bentonville AR 72712-4270 | |
| (479) 876-8866 | |
| Not Available |
| Full Name | Northwest Arkansas Internal Medicine, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2805 Mid Cities Dr, Bentonville, Arkansas |
| Authorized Official Name and Position | Ruben Tejada (OWNER) |
| Authorized Official Contact | 4797518881 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northwest Arkansas Internal Medicine, Pllc 2805 Mid Cities Dr Suite 3 Bentonville AR 72712-4270 Ph: (479) 876-8866 | Northwest Arkansas Internal Medicine, Pllc 2805 Mid Cities Dr Suite 3 Bentonville AR 72712-4270 Ph: (479) 876-8866 |
| NPI Number | 1053615211 |
|---|---|
| Provider Enumeration Date | 01/03/2011 |
| Last Update Date | 01/03/2011 |
| Medicare PECOS PAC ID | 6800072695 |
|---|---|
| Medicare Enrollment ID | O20110511000711 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053615211 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Ruben A Tejada |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053473231 PECOS PAC ID: 7911896675 Enrollment ID: I20040311001284 |
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