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General NPI Number Information
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NPI Number | 1538423587
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Entity Type | Organization
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Legal Business Name | WASHINGTON REGIONAL MEDICAL SYSTEM
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Dates
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Enumeration Date | 06/25/2012
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Last Update Date | 06/25/2012
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Provider Practice Location Address
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Address Line | 1607 S OLD MISSOURI RD
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City | SPRINGDALE
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State | AR
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Zip | 72764-5723
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Country | US
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Telephone | 479-463-4887
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Fax | 479-463-4886
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Provider Business Mailing Address
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Address Line | 1607 S OLD MISSOURI RD
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City | SPRINGDALE
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State | AR
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Zip | 72764-5723
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Country | US
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Telephone | 479-463-4887
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Fax | 479-463-4886
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Authorized Official
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Title or Position | CEO
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Name | MR. WILLIAM L BRADLEY
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Credential |
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Telephone | 479-463-6300
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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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