Organization
MEDICAL ASSOCIATES OF NORTHWEST ARKANSAS PA
Active
Organization
MEDICAL ASSOCIATES OF NORTHWEST ARKANSAS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY HURT (CFO)
(479) 571-6780
Entity
Organization
Contact information
Practice address
801 SE PLAZA AVE STE 5, BENTONVILLE, AR 72712-7925
(479) 571-0084
(479) 521-3877
Mailing address
PO BOX 1523, FAYETTEVILLE, AR 72702-1523
(479) 571-6038
(479) 582-0222
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207RG0100X
Gastroenterology Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
188437002
—
AR
01
—
56750
AR BC/BS
AR
Enumeration date
04/18/2011
Last updated
04/16/2024
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