Stacy R Tait PA

NPI #1073788212 in Fort Smith, Arkansas

Provider Information

NPI Number: 1073788212
Entity Type: Organization
Organization Name: Stacy R Tait PA
Primary Specialty: Anesthesiology
Enumeration Date: Apr 29, 2008
Last Updated: Apr 29, 2008

Practice Location

Address: 5518 ELLSWORTH RD
City: Fort Smith
State: Arkansas
ZIP Code: 72903-3222
Phone: (501) 771-4693

Authorized Official

Name: STACY TAIT, M.D.
Title: SELF
Phone: (501) 771-4693

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Anesthesiology	207L00000X	Primary

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