MEDICARE: NEW YORK INSTITUTE OF TECHNOLOGY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1619820701
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW YORK INSTITUTE OF TECHNOLOGY

Provider Business Mailing Address
First Line	:	PO BOX 1380
Second Line	:
City	:	STATE UNIVERSITY
State	:	AR
Zip	:	72467-1380
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	406 SAINT FRANCIS ST
Second Line	:
City	:	MARKED TREE
State	:	AR
Zip	:	72365-2241
Country	:	US
Telephone Number	:	870-972-2054
Fax Number	:

Authorized Official
Title or Position	:	DEAN OF NYITCOM-AR
Name	:	SHANE SPEIGHTS
Credential	:	DO
Telephone Number	:	870-680-8882

Provider Enumeration Date	:	02/18/2026
Last Update Date	:	02/18/2026

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Directions to “NEW YORK INSTITUTE OF TECHNOLOGY ” Practice Location

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