Healthcare Provider Details

I. General information

NPI: 1003850579
Provider Name (Legal Business Name): JOHN FRANK CUCHIA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 N COLLEGE AVE
FAYETTEVILLE AR
72703-1944
US

IV. Provider business mailing address

1100 N COLLEGE AVE
FAYETTEVILLE AR
72703-1944
US

V. Phone/Fax

Practice location:
  • Phone: 479-443-4301
  • Fax: 479-587-5932
Mailing address:
  • Phone: 479-443-4301
  • Fax: 479-587-5932

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberE0020
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: