Organization
MEDICAL ASSOCIATES OF NORTHWEST ARKANSAS PA
Active
Other names
MANA FM South
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY HURT (CFO)
(479) 571-6780
Entity
Organization
Contact information
Practice address
2523 E HUNTSVILLE RD, FAYETTEVILLE, AR 72701-7329
(479) 442-2822
(479) 582-1754
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
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
155662002
—
AR
01
—
5B809
AR BLUE CROSS/BLUE SHIELD
AR
Enumeration date
05/12/2006
Last updated
12/15/2025
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