Healthcare Provider Details

I. General information

NPI: 1164797965
Provider Name (Legal Business Name): SPRINGDALE HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2012
Last Update Date: 11/10/2021
Certification Date: 11/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3291 S THOMPSON ST D101
SPRINGDALE AR
72764-7043
US

IV. Provider business mailing address

3291 S THOMPSON ST D101
SPRINGDALE AR
72764-7043
US

V. Phone/Fax

Practice location:
  • Phone: 479-419-9955
  • Fax:
Mailing address:
  • Phone: 479-419-9955
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CARLOS ALBERTO SUAREZ
Title or Position: OWNER
Credential: MD
Phone: 479-419-9955