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General NPI Number Information
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NPI Number | 1285528182
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Entity Type | Organization
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Legal Business Name | VERACITY ONSITE LLC
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Dates
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Enumeration Date | 06/05/2025
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Last Update Date | 06/05/2025
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Provider Practice Location Address
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Address Line | 811 N B ST
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City | FORT SMITH
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State | AR
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Zip | 72901-2129
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Country | US
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Telephone | 479-480-4850
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Fax |
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Provider Business Mailing Address
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Address Line | 1701 BARRETT LAKES BLVD NW
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City | KENNESAW
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State | GA
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Zip | 30144-4582
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Country | US
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Telephone | 773-704-7002
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Fax |
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Authorized Official
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Title or Position | COO
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Name | AMANDA J MISHUR
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Credential |
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Telephone | 773-704-7002
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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 |
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License Number State |
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