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General NPI Number Information
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NPI Number | 1164452371
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Entity Type | Organization
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Legal Business Name | DAVID J. FOSCUE, M.D. PA
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 12/03/2008
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Provider Practice Location Address
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Address Line | 113 W CYPRESS ST
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City | WARREN
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State | AR
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Zip | 71671-2730
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Country | US
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Telephone | 870-226-2844
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Fax | 870-226-5200
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Provider Business Mailing Address
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Address Line | 113 W CYPRESS ST
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City | WARREN
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State | AR
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Zip | 71671-2730
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Country | US
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Telephone | 870-226-2844
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Fax | 870-226-5200
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Authorized Official
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Title or Position | MANAGER
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Name | TERESA J FOSCUE
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Credential |
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Telephone | 870-226-2844
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | E0549
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License Number State | AR
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