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
2630 E CITIZENS DR, SUITE 13, FAYETTEVILLE, AR 72703-4797
(479) 571-6000
(479) 571-3344
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
—
188438002
—
AR
01
—
56750
AR BC/BS
AR
Enumeration date
05/02/2011
Last updated
01/17/2024
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