Healthcare Provider Details

I. General information

NPI: 1346725355
Provider Name (Legal Business Name): TOTAL DIAGNOSTIX INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2018
Last Update Date: 07/23/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3497 WAGON WHEEL RD
SPRINGDALE AR
72762-0115
US

IV. Provider business mailing address

3497 WAGON WHEEL RD
SPRINGDALE AR
72762-0115
US

V. Phone/Fax

Practice location:
  • Phone: 877-295-2554
  • Fax: 479-347-6280
Mailing address:
  • Phone: 877-295-2554
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZE0500X
TaxonomyEEG Specialist/Technologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code246ZE0600X
TaxonomyElectroneurodiagnostic Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name: BRAD VINSON
Title or Position: CEO
Credential:
Phone: 877-295-2554