Healthcare Provider Details

I. General information

NPI: 1407805468
Provider Name (Legal Business Name): ALLERGY CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 N GREEN ACRES RD SUITE A
FAYETTEVILLE AR
72703-2807
US

IV. Provider business mailing address

2100 N GREEN ACRES RD SUITE A
FAYETTEVILLE AR
72703-2807
US

V. Phone/Fax

Practice location:
  • Phone: 479-521-3363
  • Fax: 479-521-4167
Mailing address:
  • Phone: 479-521-3363
  • Fax: 479-521-4167

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MARTHA ANN HUTSON-FINCHER
Title or Position: OWNER/PHYSICIAN
Credential: M.D.
Phone: 479-521-3363