Healthcare Provider Details

I. General information

NPI: 1417454620
Provider Name (Legal Business Name): CHRISTOPHER EDUARD SONNTAG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2018
Last Update Date: 12/23/2024
Certification Date: 12/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3276 N NORTHHILLS BLVD
FAYETTEVILLE AR
72703-4005
US

IV. Provider business mailing address

PO BOX 550
LOWELL AR
72745-0550
US

V. Phone/Fax

Practice location:
  • Phone: 479-404-2300
  • Fax: 479-404-2301
Mailing address:
  • Phone: 479-404-2300
  • Fax: 479-404-2301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberE-17047
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: