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Organization
CONWAY EMERGENCY PHYSICIANS, P.A.
Active
Organization
CONWAY EMERGENCY PHYSICIANS, P.A.
Active
Other names
Wound Care Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
PHILLIP STONE M.D. (PRESIDENT)
(501) 513-5793
Entity
Organization
Contact information
Practice address
2200 ADA AVE, CONWAY, AR 72034-4985
(501) 513-5444
Mailing address
PO BOX 727, CONWAY, AR 72033-0727
(501) 513-5793
(501) 513-5870
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
C5240
AR
208D00000X
General Practice Physician
C5964
AR
208D00000X
General Practice Physician
E0837
AR
208D00000X
General Practice Physician
E3733
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10035643
MEDICARE RAILROAD
AR
05
—
103074001
—
AR
05
—
111533001
—
AR
05
—
130948001
—
AR
05
—
150518001
—
AR
01
—
3920046
UNITED HEALTH CARE
—
01
—
930055480
MEDICARE RAILROAD
AR
01
—
930104614
MEICARE RAILROAD
—
01
—
P00089411-CP87
MEDICARE RAILROAD
AR
Enumeration date
11/14/2008
Last updated
11/20/2008
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