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General NPI Number Information
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NPI Number | 1417343328
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Entity Type | Organization
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Legal Business Name | AVIN D REKHI MD PA
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Dates
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Enumeration Date | 04/08/2015
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Last Update Date | 04/08/2015
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Provider Practice Location Address
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Address Line | 153 E MONTE PAINTER DR
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-4002
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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 2131
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City | BENTONVILLE
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State | AR
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Zip | 72712-2131
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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 | OFFICE MANAGER
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Name | KENNETHA CARDER
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Credential |
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | E-2877
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License Number State | AR
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