Stacy Robert Tait
Anesthesiologist
2910 Jenny Lind Bldg #12
Fort Smith
, Arkansas 72901-6735
Stacy Robert Tait
Anesthesiologist
2910 Jenny Lind Bldg #12
Fort Smith
, Arkansas 72901-6735
(479) 785-3555
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About
Features
Specialties
- Anesthesiologist
Languages spoken
- English
Location
First Address
- Stacy Robert Tait
- Po Box 11016
- Fort Smith, AR
- Zip : 72917-1016
- Fax : (479) 785-3555
- Phone : (479) 785-2555
Second Address
- Stacy Robert Tait
- 2910 Jenny Lind Bldg #12
- Fort Smith, AR
- Zip : 72901-6735
- Fax : (479) 785-3555
- Phone : (479) 785-2555
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207L00000X | Anesthesiologist | N6996 | AR |
National Provider Identifier
| NPI | 1003912353 |
|---|---|
| Provider Name | Stacy Robert Tait |
| First Address | Fort Smith, AR 72917-1016 |
| Second Address | Fort Smith, AR 72901-6735 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 15/09/2006 |
| Last Update Date | 22/12/2008 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 100199400A | (05) | OK |
| 112530001 | (05) | AR |
| B9005 | (02) | AR |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.