Healthcare Provider Details

I. General information

NPI: 1730166844
Provider Name (Legal Business Name): DAVID L NAYLOR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2005
Last Update Date: 07/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2425 DAVE WARD DR STE 401
CONWAY AR
72034-8686
US

IV. Provider business mailing address

2425 DAVE WARD DR STE 401
CONWAY AR
72034-8686
US

V. Phone/Fax

Practice location:
  • Phone: 501-329-3824
  • Fax: 501-327-2957
Mailing address:
  • Phone: 501-329-3824
  • Fax: 501-327-2957

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberE1459
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: