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Physicians Psychiatry & Neurology Geriatric Psychiatry

Provider NPI: 1366408973

Organization Information:
Organization is not Subpart
Authorized Official:  DAN  ECKELS  VICE PRESIDENT AND CFO  479-463-6026

Practice Location:
Tel: 479-463-2004  Fax: 479-463-7864

Business Mailing Address:
Tel: 479-463-1704  Fax: 479-463-7864

NPI Information:
NPI: 1366408973
Entity Type: Organization


PrimaryCodeCategory/DescriptionStateLicense Number
Psychiatry & Neurology
Geriatric Psychiatry

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 2084P0805X





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