CORE MED PLLC NPI 1295590453

NPI Information

  • NPI: 1295590453
  • Provider Name: CORE MED PLLC
  • Classification: General Practice - 208D00000X
  • Entity Type: Organization
  • Address: 902B S WALTON BLVD STE 18
    BENTONVILLE, AR
    ZIP 72712
  • Phone: (479) 876-8628

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NPI Details

CORE MED PLLC is a general practice in Bentonville, AR. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee CORE MED PLLC NPI is 1295590453. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

902B S WALTON BLVD STE 18
BENTONVILLE, AR
ZIP 72712-770
Phone: (479) 876-8628
Fax: (479) 876-8643

The provider's authorized official is Ryan Hasenclever .
The authorized official title is Owner and has the following contact phone number (479) 876-8628.

The enumeration date for this NPI number is 2/16/2024 and was last updated on 5/23/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208D00000XGeneral PracticeYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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