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General NPI Number Information
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NPI Number | 1033191622
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Entity Type | Organization
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Legal Business Name | NORTHWEST ARKANSAS RADIATION THERAPY INSTITUTE
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Dates
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Enumeration Date | 11/18/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5835 W SUNSET AVE
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City | SPRINGDALE
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State | AR
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Zip | 72762-0751
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Country | US
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Telephone | 479-361-2585
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Fax | 479-361-6201
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Provider Business Mailing Address
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Address Line | 5835 W SUNSET AVE
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City | SPRINGDALE
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State | AR
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Zip | 72762-0751
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Country | US
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Telephone | 479-361-2585
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Fax | 479-361-6201
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Authorized Official
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Title or Position | VP OF FINANCE
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Name | MRS. SHERRY L ANDERSON
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Credential |
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Telephone | 479-361-2585
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0203X
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Taxonomy Name | Radiation Oncology Clinic/Center
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License Number | ARK-761-BP-09-05
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License Number State | AR
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