Healthcare Provider Details

I. General information

NPI: 1780539445
Provider Name (Legal Business Name): CHARLES LAUVER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2026
Last Update Date: 02/27/2026
Certification Date: 02/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5901B RILEY PARK DR STE B
FORT SMITH AR
72916-6103
US

IV. Provider business mailing address

5901B RILEY PARK DR STE B
FORT SMITH AR
72916-6103
US

V. Phone/Fax

Practice location:
  • Phone: 479-763-3050
  • Fax:
Mailing address:
  • Phone: 479-763-3050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number236541
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: