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Contact Information

WASHINGTON REGIONAL MEDICAL SYSTEM
3336 N FUTRALL DR
FAYETTEVILLE, AR72703-4057
 Phone: 479-463-3000
 Fax: 479-469-3050
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Neurological Surgery

207T00000X 02 Physician/General Surgery
 

Clinical Neurophysiology

2084N0600X 86 Physician/Neuropsychiatry
Indicates primary specialty

NPI Profile & details for WASHINGTON REGIONAL MEDICAL SYSTEM · (Female)

NPI # 1104097500
Status Active
Credentials
Entity Individual
Enumeration date 03/13/2008
Last updated 12/17/2009 - About 16 years ago
Sole proprietor 1 Not specified
Identifiers
  • AR Medicaid 176277002
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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