| NPI | 1669462461 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA COX Cbo Support Manager 479-709-7057 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology |
| 207RN0300X Internal Medicine, Nephrology | |
| 363LF0000X Nurse Practitioner, Family | |
| 363L00000X Nurse Practitioner | |
| 208VP0000X | |
| 207RP1001X Internal Medicine, Pulmonary Disease | |
| 207RC0000X Internal Medicine, Cardiovascular Disease | |
| 2084N0400X Psychiatry & Neurology, Neurology | |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2008-06-05 |