Organization · Type 2 NPI

Peach State Medical Practice, PC

Reproductive Endocrinology Physician · Rogers, AR

NPI number 1013647569 Active

Practice location

2203 S Promenade Blvd Ste 5185
Rogers, AR 72758-8722

Call (855) 563-2639 Map

Fax (646) 905-0987

Mailing address

333 S Desplaines St Ste 201
Chicago, IL 60661-5514

Specialties and licenses

Taxonomy	Code	License
Obstetrics & Gynecology Physician	207V00000X	None listed
Reproductive Endocrinology Physician Primary	207VE0102X	None listed

Reproductive Endocrinology Physician: An obstetrician/gynecologist who is capable of managing complex problems relating to reproductive endocrinology and infertility.

4 other providers at this address

NPI record

NPI: 1013647569
Entity type: Organization (Type 2)
Issued: Jun 15, 2022
Last updated: May 20, 2024
Status: Active

Other names

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Kindbody of Ak Medical Practice, PC · doing business as
Kindbody of Ak Medical Practice, PC · doing business as

Authorized official

Dr. Fahimeh Sasan, DO
Founding Obgyn
(855) 563-2639

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1013647569

Peach State Medical Practice, PC's National Provider Identifier is 1013647569, issued on Jun 15, 2022. The primary taxonomy on file is Reproductive Endocrinology Physician (207VE0102X), and the practice location is in Rogers, AR. The record was last updated on May 20, 2024.