=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942577556
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PAMELA JAYNE BAYERS L.AC.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/28/2011
-----------------------------------------------------
Last Update Date | 11/28/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2013 N GREEN ACRES RD SUITE # E
-----------------------------------------------------
City | FAYETTEVILLE
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72703-2619
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 479-582-3300
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2013 N GREEN ACRES RD SUITE # E
-----------------------------------------------------
City | FAYETTEVILLE
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72703-2619
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 479-582-3300
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | L.AC.022
-----------------------------------------------------
License Number State | AR
-----------------------------------------------------