Provider Demographics
NPI:1366409930
Name:FOSCUE, DAVID J (MD , PA)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:J
Last Name:FOSCUE
Suffix:
Gender:M
Credentials:MD , PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:513 N SHILOH ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72764-3343
Mailing Address - Country:US
Mailing Address - Phone:479-419-9902
Mailing Address - Fax:479-419-9950
Practice Address - Street 1:1615 W PERSIMMON ST
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72756-3359
Practice Address - Country:US
Practice Address - Phone:479-636-7192
Practice Address - Fax:479-621-9749
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-0549207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR127887001Medicaid
ARG10776Medicare UPIN