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FAYETTEVILLE SURGICAL ASSOC PA
NPI 1013084631
Specialist in Fayetteville, AR

Active since November 29, 2006
3264 N. NORTH HILLS BLVD., FAYETTEVILLE, AR 72703(479) 521-3300(479) 521-4914 Get Directions Write a Review

NPPES record last updated: July 22, 2013. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Fayetteville Surgical Assoc Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FAYETTEVILLE SURGICAL ASSOC PA (NPI 1013084631) is a healthcare organization registered as a specialist in Fayetteville, Arkansas and active in the NPI registry since November 2006. The organization lists Gwen S Mathis, Clinic Administrator, as its authorized official.

NPPES Registry Identity

NPI1013084631
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameFAYETTEVILLE SURGICAL ASSOC PA
Location Address3264 N. NORTH HILLS BLVD.Fayetteville, AR 72703-4005
Mailing Address3264 N. North Hills Blvd.Fayetteville, AR 72703-4005 · (479) 521-3300 · Fax (479) 521-4914
Phone(479) 521-3300
Fax(479) 521-4914
Organization SubpartNo
Authorized OfficialGwen S MathisClinic Administrator · (479) 521-3300
Enumeration DateNovember 29, 2006
Last NPPES UpdateJuly 22, 2013
✔ NPI 1013084631 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
3264 N. NORTH HILLS BLVD., Fayetteville, AR 72703
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Other Identifiers 2

Medicaid111799002AR
Medicare PIN57127AR

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JEFFREY D. BELL M.D.
Surgery
3264 N. NORTH HILLS BLVD., 377TH MEDICAL GROUP
FAYETTEVILLE, AR 72703
Washington County (479) 521-3300

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fayetteville Surgical Assoc PA's NPI number?

The NPI number for Fayetteville Surgical Assoc PA is 1013084631. It was assigned to this organization in the NPPES registry on November 29, 2006.

Where is Fayetteville Surgical Assoc PA located?

Fayetteville Surgical Assoc PA is located at 3264 N. North Hills Blvd., Fayetteville, AR 72703. The listed phone number is (479) 521-3300.

What is Fayetteville Surgical Assoc PA's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Fayetteville Surgical Assoc PA was last updated on July 22, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.