Northwest Arkansas Podiatry Center, Inc.

NPI #1194868281 in Fayetteville, Arkansas

Provider Information

NPI Number: 1194868281
Entity Type: Organization
Organization Name: Northwest Arkansas Podiatry Center, Inc.
Primary Specialty: Podiatrist
Enumeration Date: Feb 15, 2007
Last Updated: Jan 3, 2011

Practice Location

Address: 125 W SUNBRIDGE DR
Address 2: SUITE 1
City: Fayetteville
State: Arkansas
ZIP Code: 72703-1899
Phone: (479) 251-9200

Authorized Official

Name: DR. PHETSAMONE PETER XAYSANASY, DPM
Title: OWNER
Phone: (479) 251-9200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Podiatrist	213E00000X	Primary

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