Organization
CONWAY GASTROENTEROLOGY, PA
Active
Organization
CONWAY GASTROENTEROLOGY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN D HEATH MD (PHYSICIAN)
(501) 513-0799
Entity
Organization
Contact information
Practice address
455 HOGAN LN, CONWAY, AR 72034-8201
(501) 513-0799
(501) 513-0798
Mailing address
PO BOX 10780, CONWAY, AR 72034-0013
(501) 513-0799
(501) 513-0798
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
MC-1598
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
128136002
—
AR
Enumeration date
06/30/2005
Last updated
08/01/2012
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