Healthcare Provider Details

I. General information

NPI: 1255822524
Provider Name (Legal Business Name): ARKANSAS HEARING AND AUDIOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2018
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

855 S GERMAN LN STE 2
CONWAY AR
72034-6479
US

IV. Provider business mailing address

855 S GERMAN LN
CONWAY AR
72034-6334
US

V. Phone/Fax

Practice location:
  • Phone: 501-205-1215
  • Fax: 501-205-1250
Mailing address:
  • Phone: 501-205-1215
  • Fax: 501-205-1250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name: COURTNEY MATYJA
Title or Position: CEO
Credential: AUD
Phone: 501-205-1215