Healthcare Provider Details

I. General information

NPI: 1154354157
Provider Name (Legal Business Name): HEALING ARTS MEDICAL CENTER PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 12/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4125 E MISSION BLVD STE 2
FAYETTEVILLE AR
72703-4445
US

IV. Provider business mailing address

4125 E MISSION BLVD STE 2
FAYETTEVILLE AR
72703-4445
US

V. Phone/Fax

Practice location:
  • Phone: 479-582-1755
  • Fax: 479-582-1778
Mailing address:
  • Phone: 479-464-5829
  • Fax: 479-725-2395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM S PIECHAL
Title or Position: OWNER
Credential: DO
Phone: 479-582-1755