Organization
NORTHEAST ARKANSAS OMFS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW L MCDONOUGH (CEO)
(870) 931-3000
Entity
Organization
Contact information
Practice address
2609 BROWNS LN, JONESBORO, AR 72401-7227
(870) 931-3000
(870) 931-0190
Mailing address
2609 BROWNS LN, JONESBORO, AR 72401-7227
(870) 931-3000
(870) 931-0190
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
225890679
—
AR
Enumeration date
01/24/2022
Last updated
01/24/2022
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