| Premise Health - Fayetteville | |
|
2907 E Joyce Blvd Ste 6 Fayetteville AR 72703-5390 | |
| (479) 442-9900 | |
| (479) 442-9903 |
| Full Name | Premise Health - Fayetteville |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 2907 E Joyce Blvd Ste 6, Fayetteville, Arkansas |
| Authorized Official Name and Position | Peter J Vasquez (PRESIDENT) |
| Authorized Official Contact | 8444077557 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Premise Health - Fayetteville 5500 Maryland Way Ste 120 Brentwood TN 37027-4993 Ph: () - | Premise Health - Fayetteville 2907 E Joyce Blvd Ste 6 Fayetteville AR 72703-5390 Ph: (479) 442-9900 |
| NPI Number | 1174003685 |
|---|---|
| Provider Enumeration Date | 08/15/2018 |
| Last Update Date | 04/29/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174003685 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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