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NPI Code Detail

MEDICARE: CUSTODY CARE SERVICES

MEDICARE: CUSTODY CARE SERVICES
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
1207QA0505XAdult Medicine Physician

General Provider Information

NPI Number : 1881425411
Entity Type Code : Organization
Provider Name (Legal Business Name) : CUSTODY CARE SERVICES
Provider Business Mailing Address
First Line : 2707 MARKET TRCE
Second Line :
City : FORT SMITH
State : AR
Zip : 72908-8694
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2707 MARKET TRCE
Second Line :
City : FORT SMITH
State : AR
Zip : 72908-8694
Country : US
Telephone Number : 479-719-3406
Fax Number :
Authorized Official
Title or Position : PHYSICIAN/OWNER
Name : BRETT WHATCOTT
Credential : DO
Telephone Number : 479-719-3406
Provider Enumeration Date : 08/14/2024
Last Update Date : 08/14/2024

Similar Medicare Providers

1134169816 — BRETT D WHATCOTT DO
Practice Location Address:
2707 MARKET TRCE
FORT SMITH, AR
72908-8694
Practice Phone: 479-434-3600
Practice Fax: 833-992-0797
1689866725 — DR. THOMAS BENJAMIN DE MIRANDA M.D.
Practice Location Address:
2707 MARKET TRCE
FORT SMITH, AR
72908-8694
Practice Phone: 479-434-3600
Practice Fax: 833-992-0797
1871986315 — MR. BARRY PAUL HOLLOWAY PA-C
Practice Location Address:
2707 MARKET TRACE
FORT SMITH, AR
72908-8694
Practice Phone: 479-434-3600
Practice Fax: 833-992-0797
1417550245 — MRS. COURTNEY NICOLE GUEYE
Practice Location Address:
2707 MARKET TRCE
FORT SMITH, AR
72908-8694
Practice Phone: 479-434-3600
Practice Fax:
1285389262 — KRISTINA M DEAN APRN, FNP-BC
Practice Location Address:
2707 MARKET TRCE
FORT SMITH, AR
72908-8694
Practice Phone: 479-434-3600
Practice Fax: 833-992-0797
1760242440 — TBD HEALTH ENTERPRISES OF ARKANSAS PLLC
Practice Location Address:
2707 MARKET TRCE
FORT SMITH, AR
72908-8694
Practice Phone: 479-434-3600
Practice Fax: 833-992-0797

Directions to “CUSTODY CARE SERVICES ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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