Organization
NORTHWEST ARKANSAS NEUROSURGERY CLINIC, PA
Active
Parent organization
NORTHWEST ARKANSAS NEUROSURGERY CLINIC, PA
Other names
Total Spine
Organization subpart
Yes
Provider details
NPI number
Legal business name
NORTHWEST ARKANSAS NEUROSURGERY CLINIC, PA
Authorized official
MS. JENNIFER G MATHIS (OFFICE ADMINISTRATOR)
(479) 521-0900
Entity
Organization
Contact information
Practice address
5501 WILLOW CREEK DR, SUITE 203, SPRINGDALE, AR 72762-8704
(479) 521-0900
(479) 521-7284
Mailing address
5501 WILLOW CREEK DR, SUITE 203, SPRINGDALE, AR 72762-8704
(479) 521-0900
(479) 521-7284
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5C180
BLUE CROSS/ BLUE SHIELD
AR
Enumeration date
06/28/2006
Last updated
09/14/2010
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