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NPI Code Detail

MEDICARE: CHRISTA BARTLETT

MEDICARE: CHRISTA BARTLETT
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
1363AM0700XMedical Physician AssistantP-T1546AR

General Provider Information

NPI Number : 1770954927
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTA BARTLETT
Provider Business Mailing Address
First Line : PO BOX 2
Second Line :
City : DELAWARE
State : AR
Zip : 72835-0002
Country : US
Telephone Number : 479-229-8000
Fax Number : 479-477-3925
Provider Business Practice Location Address
First Line : 1652 STATE HIGHWAY 22 W
Second Line :
City : DARDANELLE
State : AR
Zip : 72834-2909
Country : US
Telephone Number : 479-229-8000
Fax Number : 479-477-3925
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/14/2015
Last Update Date : 10/14/2015

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Directions to “ CHRISTA BARTLETT ” Practice Location

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