Healthcare Provider Details

I. General information

NPI: 1043023104
Provider Name (Legal Business Name): LANDRY COMPTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2025
Last Update Date: 01/30/2025
Certification Date: 01/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 HIGHWAY 65 S
CLINTON AR
72031-6588
US

IV. Provider business mailing address

3100 IRBY DR APT 4209
CONWAY AR
72034-7766
US

V. Phone/Fax

Practice location:
  • Phone: 501-745-7000
  • Fax:
Mailing address:
  • Phone: 325-262-3550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: