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General NPI Number Information
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NPI Number | 1306525845
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Entity Type | Organization
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Legal Business Name | JUNIPER HEALTH PA
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Dates
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Enumeration Date | 07/12/2023
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Last Update Date | 07/12/2023
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Provider Practice Location Address
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Address Line | 448 SW D ST
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City | BENTONVILLE
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State | AR
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Zip | 72712-5864
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Country | US
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Telephone | 479-601-2314
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Fax | 888-664-5545
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Provider Business Mailing Address
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Address Line | PO BOX 3106
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City | BENTONVILLE
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State | AR
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Zip | 72712-7711
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Country | US
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Telephone | 479-601-2314
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Fax | 888-664-5545
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Authorized Official
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Title or Position | PRESIDENT
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Name | VALERIE GERMAN
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Credential | MD
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Telephone | 479-601-2314
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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