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DR. PHETSAMONE PETER XAYSANASY D.P.M.
NPI 1063456184
Podiatrist in Fayetteville, AR

Active since June 16, 2006
125 W SUNBRIDGE DR, SUITE 1, FAYETTEVILLE, AR 72703(479) 251-9200 Get Directions Write a Review

NPPES record last updated: January 3, 2011. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Phetsamone Peter Xaysanasy D.p.m. NPPES

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

DR. PHETSAMONE PETER XAYSANASY D.P.M. (NPI 1063456184) is an individual podiatrist in Fayetteville, Arkansas, licensed in Arkansas (193) and active in the NPI registry since June 2006.

NPPES Registry Identity

NPI1063456184
Entity TypeIndividualMale
Primary Taxonomy213E00000X
Provider Legal NameDR. PHETSAMONE PETER XAYSANASYCredential: D.P.M.
Location Address125 W SUNBRIDGE DR, SUITE 1Fayetteville, AR 72703-1899
Mailing Address125 W Sunbridge Dr, Suite 1Fayetteville, AR 72703-1899 · (479) 251-9200
Phone(479) 251-9200
Sole ProprietorNo
Enumeration DateJune 16, 2006
Last NPPES UpdateJanuary 3, 2011
✔ NPI 1063456184 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPodiatristPodiatric Medicine & Surgery Service Providers
Taxonomy Code213E00000X
License✔ Licensed in AR · 193
Definition
A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.
125 W SUNBRIDGE DR, Fayetteville, AR 72703
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Other Identifiers 3

Medicare PIN5L630AR
Medicare UPINU82695AR
Medicaid14086717AR

Other Providers at the Same Location NPPES 3

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

MRS. SARAH MATOUSEK MS CCC SLP
Speech-Language Pathologist
125 W SUNBRIDGE DR
FAYETTEVILLE, AR 72703
Washington County (479) 587-9201
NORTHWEST ARKANSAS PODIATRY CENTER, INC.
Podiatrist
125 W SUNBRIDGE DR, SUITE 1
FAYETTEVILLE, AR 72703
Washington County (479) 251-9200
ARCHWAY THERAPY SERVICES
Psychologist
125 W SUNBRIDGE DR
FAYETTEVILLE, AR 72703
Washington County (479) 587-9201

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 Phetsamone Xaysanasy's NPI number?

The NPI number for Phetsamone Xaysanasy is 1063456184. It was assigned to this individual provider in the NPPES registry on June 16, 2006.

Where is Phetsamone Xaysanasy located?

Phetsamone Xaysanasy practices at 125 W Sunbridge Dr Suite 1, Fayetteville, AR 72703. The listed phone number is (479) 251-9200.

What is Phetsamone Xaysanasy's specialty?

The primary specialty registered for this NPI is Podiatrist with taxonomy code 213E00000X.

When was this NPI record last updated?

The NPPES record for Phetsamone Xaysanasy was last updated on January 3, 2011. NPI Profile syncs with the weekly NPPES data releases published by CMS.