NPI 1194068734

W.A. Lucky LLC.

Organisation Health Maintenance Organization Fayetteville, AR

Practice location

Address: 1753 N College Ave STE. 100, Fayetteville, AR 72703-2650
Phone: (479) 442-5677

Authorised official

Name: Larry Walker
Title: Owner
Phone: (479) 442-5677

Registered specialties

Health Maintenance Organization Primary

Managed Care Organizations Taxonomy 302R00000X Licence A003800 (AR)

Other Health Maintenance Organization providers in Arkansas →

Registry record

NPI: 1194068734
Entity type: Organization
NPI issued: 2 Apr 2013
Record last updated: 2 Apr 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.