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General NPI Number Information
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NPI Number | 1548530694
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Entity Type | Organization
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Legal Business Name | HEDBERG ALLERGY AND ASTHMA CENTER, PA
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Dates
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Enumeration Date | 01/06/2012
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Last Update Date | 01/06/2012
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Provider Practice Location Address
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Address Line | 1585 E RAIN FOREST RD
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City | FAYETTTEVILLE
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State | AR
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Zip | 72703
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Country | US
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Telephone | 479-301-8887
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Fax | 479-464-9949
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Provider Business Mailing Address
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Address Line | 700 S 52ND ST
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City | ROGERS
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State | AR
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Zip | 72758-8605
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Country | US
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Telephone | 479-464-8887
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Fax | 479-464-9949
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CURTIS LARS HEDBERG
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Credential | MD
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Telephone | 479-464-8887
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207KA0200X
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Taxonomy Name | Allergy Physician
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License Number |
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License Number State | AR
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