DR. HESSEL KOOISTRA III


Address: 10971 Rocky Creek Rd, Fayetteville, AR 72701-0614
Phone: 4798412736

DR. HESSEL KOOISTRA III (NPI# 1053754622) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1053754622
Entity Type Individual
Full Name DR. HESSEL KOOISTRA III
Credential M.D.
Practice Address 10971 Rocky Creek Rd
Fayetteville
AR 72701-0614
Mailing Address 10975 Rocky Creek Rd
Fayetteville
AR 72701-0614
Practice Telephone 4798412736
Mailing Telephone 4798412736
Enumeration Date 2013-04-12
Last Update Date 2013-04-12
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 208D00000X General Practice E-2570 AR Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
TX P000516J3 05

Office Location

Street Address 10971 ROCKY CREEK RD
City FAYETTEVILLE
State AR
Zip Code 72701-0614

Providers in the same location

NPI Name Taxonomy Address Enumeration
1326489568 Linda Marie Kooistra Chiropractor 10971 Rocky Creek Rd, Fayetteville, AR 72701-0614 2013-07-16

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Taxonomy Information

Taxonomy Code 208D00000X
Grouping Allopathic & Osteopathic Physicians
Classification General Practice

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1700297033 Washington Regional Medical System General Practice 3 E. Appleby Road, Suite 101, Fayetteville, AR 72703 2014-05-08
1861636607 John James Sacco General Practice 5018 Worthington Way, Fayetteville, NY 13066-8703 2009-04-23
1093877441 Michael R Ressal General Practice 3415 C1 Melrose Road, Fayetteville, NC 28304-1608 2006-12-14
1184727711 Donald Eric Milmore General Practice 120 Walnut Street, Fayetteville, NY 13066-2028 2006-09-07
1710993654 Scott David Fedosky General Practice 2603 Main Dr, Suite # 6, Fayetteville, AR 72704-5278 2006-07-31
1356377741 Linda M Ekman General Practice 117 E Sycamore St, Fayetteville, AR 72703-2540 2006-06-25
1902832660 Janet Lynn Titus General Practice 63 W Sunbridge Dr, Fayetteville, AR 72703-1825 2006-06-24
1720020712 Diane Elizabeth Ashby General Practice 207 W Maple Ave, Fayetteville, WV 25840-1413 2006-06-12
1427008093 Medical Associates of Northwest Arkansas Pa General Practice 1188 N Salem Rd Ste 6, Fayetteville, AR 72704-8803 2006-05-12
1164472908 Johnny P Adkins General Practice 3053 N College Avenue, Fayetteville, AR 72703 2006-05-11
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Competitor

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City FAYETTEVILLE
Zip Code 72701

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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