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General NPI Number Information
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NPI Number | 1730131731
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Entity Type | Organization
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Legal Business Name | SPRINGDALE BENTONVILLE SURGERY CENTER LP
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 02/03/2009
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Provider Practice Location Address
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Address Line | 601 W MAPLE AVE SUITE 302
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City | SPRINGDALE
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State | AR
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Zip | 72764-5335
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Country | US
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Telephone | 479-750-5800
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Fax | 479-685-7262
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Provider Business Mailing Address
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Address Line | PO BOX 842494
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City | DALLAS
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State | TX
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Zip | 75284-2494
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Country | US
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Telephone | 479-750-5800
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Fax | 479-685-7262
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Authorized Official
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Title or Position | DIRECTOR, BUSINESS OFFICE SUPPORT
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Name | LAURIE HOLTSFORD
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Credential |
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Telephone | 615-465-7466
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | AR4278
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License Number State | AR
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