Tabathea Willet
Individual provider Active NPI Driver · Fort Smith, AR
NPI 1467201731 · NPPES record last updated May 17, 2024
Key facts
- NPI
- 1467201731
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- License
- T083266333 (OK)
- Practice address
- 5400 Euper LN
Fort Smith, AR 72903-3232 - Phone
- (479) 755-6601
- NPI assigned
- May 17, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| T083266333 | OK | MD | Driver |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kids Unlimited Learning Academy of Fort Smith | Current |
Accepting new patients | |
| Miracle Kids Success Academy Central | Current |
Accepting new patients | |
| Kids Unlimited Learning Academy of Ft. Smith | Past |
Accepting new patients |
Locations
5400 Euper Ln
Fort Smith, AR 72903
Phone (479) 300-6400
3127 Southwest Dr
Jonesboro, AR 72404
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | T083266333 | OK | Yes |
Addresses
Primary practice location
5400 Euper LN
Fort Smith, AR 72903-3232
Mailing address
3127 Southwest Dr
Jonesboro, AR 72404-8404
Phone (870) 336-8100
Other providers in Fort Smith, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 17, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.