Ozark Dermatology Clinic
NPI #1134207483 in Fayetteville, Arkansas
Provider Information
- NPI Number
- 1134207483
- Entity Type
- Organization
- Organization Name
- Ozark Dermatology Clinic
- Primary Specialty
- Specialist
- Enumeration Date
- Nov 2, 2006
- Last Updated
- Feb 22, 2022
Practice Location
- Address
- 4375 N. VANTAGE DRIVE
- Address 2
- SUITE 305
- City
- Fayetteville
- State
- Arkansas
- ZIP Code
- 72703-4984
- Phone
- (479) 443-5100
Authorized Official
- Name
- DIANE WILLIAMS
- Title
- CREDENTIALING MANAGER
- Phone
- (479) 335-1831
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist |
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