Fayetteville Surgical Assoc Pa

LBN: Fayetteville Surgical Assoc Pa
Fayetteville Surgical Assoc Pa is an health care organization with primary practice located at 3264 N. North Hills Blvd. , Fayetteville AR 72703-4005. The organization recently has only one registered license in Other Service Providers / Specialist, which is considered as the primary health care specialty. Fayetteville Surgical Assoc Pa can be contacted via phone (479) 521-3300, or through Mathis, Gwen S via phone (479) 521-3300.

Contact Information

Primary practice address
3264 N. North Hills Blvd. Fayetteville AR 72703-4005
Phone: (479) 521-3300
Fax: (479) 521-4914
Website:
Map and Directions
Authorized official contact:
Name: Mathis, Gwen S
Phone: (479) 521-3300

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X

Profile Details

NPI number 1013084631
LBN Legal business name Fayetteville Surgical Assoc Pa
DBA Doing business as
Authorized official Mathis, Gwen S
Entity Organization
Organization subpart 1 No
Enumeration date Nov 29th, 2006
Last updated Jul 22nd, 2013 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013084631 NPPES
Arkansas MEDICAID 111799002

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