MEDICARE: ALLERGY CARE CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207K00000X	Allergy & Immunology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CS3629	OTHER	AR	CLINIC RAILROAD MC #
2	57177	OTHER	AR	CLINIC BCBS PROV #

General Provider Information

NPI Number	:	1407805468
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLERGY CARE CENTER

Provider Business Mailing Address
First Line	:	2100 N GREEN ACRES RD
Second Line	:	SUITE A
City	:	FAYETTEVILLE
State	:	AR
Zip	:	72703-2807
Country	:	US
Telephone Number	:	479-521-3363
Fax Number	:	479-521-4167

Provider Business Practice Location Address
First Line	:	2100 N GREEN ACRES RD
Second Line	:	SUITE A
City	:	FAYETTEVILLE
State	:	AR
Zip	:	72703-2807
Country	:	US
Telephone Number	:	479-521-3363
Fax Number	:	479-521-4167

Authorized Official
Title or Position	:	OWNER/PHYSICIAN
Name	:	DR. MARTHA ANN HUTSON-FINCHER
Credential	:	M.D.
Telephone Number	:	479-521-3363

Provider Enumeration Date	:	05/08/2006
Last Update Date	:	08/22/2020

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Directions to “ALLERGY CARE CENTER ” Practice Location

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