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Contact Information

SUSAN M AVERITT, MD
5501 WILLOW CREEK DR. STE 203
SPRINGDALE, AR72762
 Phone: 479-575-9359
 Fax: 479-575-9415
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for SUSAN M AVERITT · (Female)

NPI # 1356304091
Status Active
Credentials MD
Entity Individual
Enumeration date 04/11/2006
Last updated 07/21/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • AR License # E2459
  • OK License # 23620
  • AR Medicaid 140067001
  • MO Medicaid 1356304091
  • OK Medicaid 200016780A
  • OK Other 74502A050 CHAMPUS (WPS)
  • OK Other 1324230001 PALMETTO DME
  • OK Other 200016780A SOONER PCP
  • OK Other H14901 STERLING OPTION 1
  • OK Other 731310891028 TRICARE SOUTH
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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