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509 E Millsap Rd Ste 107 Fayetteville AR 72703-4862 | |
(479) 480-7150 | |
(479) 968-1673 |
Full Name | |
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Speciality | Internal Medicine |
Location | 509 E Millsap Rd Ste 107, Fayetteville, Arkansas |
Authorized Official Name and Position | Benjamin Wagner Carlyle (AUTHORIZED OFFICIAL) |
Authorized Official Contact | 4794986700 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 9178 Russellville AR 72811-9178 Ph: (800) 824-4094 | 509 E Millsap Rd Ste 107 Fayetteville AR 72703-4862 Ph: (479) 480-7150 |
NPI Number | 1508675612 |
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Provider Enumeration Date | 01/03/2025 |
Last Update Date | 01/27/2025 |
Identifier | Type | State | Issuer |
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1508675612 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal 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 | |