Provider Demographics
NPI:1124252275
Name:SCHWEIGHART, FARLEY LYNN (PT)
Entity type:Individual
Prefix:
First Name:FARLEY
Middle Name:LYNN
Last Name:SCHWEIGHART
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1871 FALLS BLVD N
Mailing Address - Street 2:
Mailing Address - City:WYNNE
Mailing Address - State:AR
Mailing Address - Zip Code:72396-4026
Mailing Address - Country:US
Mailing Address - Phone:870-208-8989
Mailing Address - Fax:870-208-8107
Practice Address - Street 1:1871 FALLS BLVD N
Practice Address - Street 2:
Practice Address - City:WYNNE
Practice Address - State:AR
Practice Address - Zip Code:72396-4026
Practice Address - Country:US
Practice Address - Phone:870-208-8989
Practice Address - Fax:870-208-8107
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-04
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1187853225100000X
OK4250225100000X
ARPT4281225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200243030AMedicaid
OK100522047OtherMEDICARE PTAN
OK1124252275OtherTRICARE
OK1124252275OtherBCBS
OK1124252275Medicare PIN
OKOK403314Medicare PIN