Healthcare Provider Details

I. General information

NPI: 1649133406
Provider Name (Legal Business Name): CASSIDY LYNN FRONK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 SALEM RD STE 1
CONWAY AR
72034-6166
US

IV. Provider business mailing address

2400 S 48TH ST
SPRINGDALE AR
72762-6683
US

V. Phone/Fax

Practice location:
  • Phone: 501-336-8300
  • Fax: 501-329-5508
Mailing address:
  • Phone: 479-750-2020
  • Fax: 479-750-2020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: