Healthcare Provider Details

I. General information

NPI: 1033097738
Provider Name (Legal Business Name): DR. BLAKE PSCHIER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2025
Last Update Date: 08/22/2025
Certification Date: 08/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 W DICKSON ST
FAYETTEVILLE AR
72701-5219
US

IV. Provider business mailing address

908 S BRAMBLING LN
FAYETTEVILLE AR
72701-5651
US

V. Phone/Fax

Practice location:
  • Phone: 479-442-6262
  • Fax:
Mailing address:
  • Phone: 479-719-7119
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPD17472
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: