# CONWAY REGIONAL MEDICAL CENTER, INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CONWAY REGIONAL MEDICAL CENTER,INC
- **Other names:** Cardiovascular and Thoracic Surgery of Conway
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1588975825
- **Legal business name:** CONWAY REGIONAL MEDICAL CENTER,INC
- **Authorized official:** WILLIAM PACK (CFO)
- **Authorized official phone:** (501) 450-2112

## Contact information

- **Practice address:** 525 WESTERN AVE, SUITE 302, CONWAY, AR 72034-4967
- **Practice address phone:** (501) 328-5515
- **Practice address fax:** (501) 328-5518
- **Mailing address:** PO BOX 9662, CONWAY, AR 72033-9662
- **Mailing address phone:** (501) 852-1363
- **Mailing address fax:** (501) 328-5518

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | NULL | Yes |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/01/2010
- **Last updated:** 11/09/2023