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General NPI Number Information
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NPI Number | 1235148719
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Entity Type | Individual
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Provider Name | CHARLES R. BELT M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 525 N GARLAND AVE
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City | FAYETTEVILLE
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State | AR
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Zip | 72701-3110
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Country | US
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Telephone | 479-575-6479
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Fax |
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Provider Business Mailing Address
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Address Line | 904 E RODGERS DR
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City | FAYETTEVILLE
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State | AR
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Zip | 72701-4456
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Country | US
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Telephone | 479-587-8039
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | C-5120
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License Number State | AR
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