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General NPI Number Information
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NPI Number | 1295858967
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Entity Type | Individual
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Provider Name | GARNEY H FENDLEY MD
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Gender | Male
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Dates
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Enumeration Date | 04/09/2007
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Last Update Date | 08/01/2018
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Provider Practice Location Address
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Address Line | 3215 N. NORTH HILLS BLVD
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-4424
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Country | US
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Telephone | 479-463-7102
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Fax | 479-463-7864
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Provider Business Mailing Address
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Address Line | PO BOX 550
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City | LOWELL
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State | AR
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Zip | 72745
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Country | US
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Telephone | 479-463-7775
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Fax | 479-463-7187
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD.204733
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | AR
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | E-5788
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License Number State | AR
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