Fayetteville Surgical Assoc PA
NPI #1013084631 in Fayetteville, Arkansas
Provider Information
- NPI Number
- 1013084631
- Entity Type
- Organization
- Organization Name
- Fayetteville Surgical Assoc PA
- Primary Specialty
- Specialist
- Enumeration Date
- Nov 29, 2006
- Last Updated
- Jul 22, 2013
Practice Location
- Address
- 3264 N. NORTH HILLS BLVD.
- City
- Fayetteville
- State
- Arkansas
- ZIP Code
- 72703-4005
- Phone
- (479) 521-3300
Authorized Official
- Name
- MRS. GWEN S MATHIS
- Title
- CLINIC ADMINISTRATOR
- Phone
- (479) 521-3300
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist |
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