Provider Demographics
NPI:1265731608
Name:DR. BEVERLY J. FOSTER, PA
Entity type:Organization
Organization Name:DR. BEVERLY J. FOSTER, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:D,C,
Authorized Official - Phone:501-371-0253
Mailing Address - Street 1:PO BOX 2419
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72203-2419
Mailing Address - Country:US
Mailing Address - Phone:501-371-9994
Mailing Address - Fax:501-224-0784
Practice Address - Street 1:2701 W MARKHAM ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5926
Practice Address - Country:US
Practice Address - Phone:501-371-0152
Practice Address - Fax:501-371-0253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-24
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR971111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Single Specialty