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Contact Information

NORTHWEST ARKANSAS PODIATRY CENTER, INC.
125 W SUNBRIDGE DR
SUITE 1
FAYETTEVILLE, AR72703-1899
 Phone: 479-251-9200
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for NORTHWEST ARKANSAS PODIATRY CENTER, INC.

NPI Number 1194868281
LBN Legal business name NORTHWEST ARKANSAS PODIATRY CENTER, INC.
Authorized official PHETSAMONE XAYSANASY - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 02/15/2007
Last updated 01/03/2011 - About 15 years ago
Identifiers
AR License # 193
AR Medicaid 146684748
AR Other 5C648 BLUECROSS BLUESHIELD
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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