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General NPI Number Information
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NPI Number | 1780215871
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Entity Type | Organization
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Legal Business Name | PAULS RHEUMATOLOGY CLINIC, INCORPORATED
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Dates
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Enumeration Date | 01/28/2020
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Last Update Date | 01/28/2020
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Provider Practice Location Address
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Address Line | 24 W SUNBRIDGE DR
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-1822
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Country | US
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Telephone | 316-734-6742
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Fax |
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Provider Business Mailing Address
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Address Line | 224 OHARA LN
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City | SPRINGDALE
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State | AR
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Zip | 72762-9012
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Country | US
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Telephone | 316-734-6742
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Fax |
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Authorized Official
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Title or Position | INCORPORATOR/ORGANIZER
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Name | RHONDA R PAULS
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Credential | APRN
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Telephone | 316-734-6742
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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