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General NPI Number Information
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NPI Number | 1487904009
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Entity Type | Organization
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Legal Business Name | EMERGENCY MEDICINE OF ARKANSAS PLLC
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Dates
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Enumeration Date | 09/11/2012
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Last Update Date | 10/31/2014
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Provider Practice Location Address
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Address Line | 1706 SE WALTON BLVD SUITE 4
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City | BENTONVILLE
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State | AR
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Zip | 72712-3200
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Country | US
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Telephone | 479-464-0400
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Fax | 479-268-5688
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Provider Business Mailing Address
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Address Line | 1706 SE WALTON BLVD SUITE 4
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City | BENTONVILLE
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State | AR
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Zip | 72712-3200
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Country | US
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Telephone | 479-464-0400
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Fax | 479-268-5688
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | WARREN SCOTT LAFFERTY
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Credential | MD
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Telephone | 479-464-0400
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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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