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General NPI Number Information
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NPI Number | 1770194441
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Entity Type | Organization
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Legal Business Name | GENESISCARE LANDMARK ARKANSAS CANCER CARE PA
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Dates
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Enumeration Date | 08/14/2020
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Last Update Date | 01/27/2023
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Provider Practice Location Address
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Address Line | 2526 S PINNACLE HILLS PKWY
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City | ROGERS
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State | AR
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Zip | 72758-8939
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Country | US
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Telephone | 479-271-8900
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Fax | 479-715-8060
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Provider Business Mailing Address
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Address Line | 2270 COLONIAL BLVD
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City | FORT MYERS
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State | FL
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Zip | 33907-1412
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Country | US
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Telephone | 239-931-7342
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Fax | 239-931-7385
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Authorized Official
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Title or Position | PRESIDENT
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Name | JEFFREY T. TRIPLETT
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Credential | MD
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Telephone | 479-271-8900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0000X
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Taxonomy Name | Hematology (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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