# CONWAY REGIONAL MEDICAL CENTER INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Conway Regional Endocrinology and Diabetes Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255095139
- **Authorized official:** WILLIAM PACK (CFO)
- **Authorized official phone:** (501) 450-2112

## Contact information

- **Practice address:** 525 WESTERN AVE STE 305B, CONWAY, AR 72034-4982
- **Practice address phone:** (501) 205-4990
- **Practice address fax:** (501) 205-4993
- **Mailing address:** PO BOX 9662, CONWAY, AR 72033-9662
- **Mailing address phone:** (501) 852-1363
- **Mailing address fax:** (501) 852-1364

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | NULL | Yes |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/26/2021
- **Last updated:** 11/09/2023