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WASHINGTON REGIONAL MEDICAL SYSTEM

Physicians Psychiatry & Neurology Geriatric Psychiatry

Provider NPI: 1366408973

Organization Information:
Organization Name:  WASHINGTON REGIONAL MEDICAL SYSTEM
Organization is not Subpart
Authorized Official:  DAN  ECKELS  VICE PRESIDENT AND CFO  479-463-6026

Practice Location:
3215 N NORTHHILLS BLVD WASHINGTON REGIONAL PSYCHIATRIC CLINIC FAYETTEVILLE, AR 72703-4424 US
Tel: 479-463-2004  Fax: 479-463-7864

Business Mailing Address:
12 E APPLEBY CLINIC ADMINISTRATION FAYETTEVILLE, AR 72703 US
Tel: 479-463-1704  Fax: 479-463-7864

NPI Information:
NPI: 1366408973
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y2084P0805XPhysicians
Psychiatry & Neurology
Geriatric Psychiatry

Other Provider Identifiers:

IssuerNumberStateType
148784002AR05



American Medical Association 2012 taxonomy code information

Code: 2084P0805X

Type:

Classification:



Definition:



MEDICAL JOBS AR - Page 1

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