Healthcare Provider Details

I. General information

NPI: 1982931192
Provider Name (Legal Business Name): NORTH ARKANSAS SURGERY CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2009
Last Update Date: 11/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 W SHERMAN AVE SUITE B
HARRISON AR
72601-2743
US

IV. Provider business mailing address

715 W SHERMAN AVE SUITE B
HARRISON AR
72601-2743
US

V. Phone/Fax

Practice location:
  • Phone: 870-741-8343
  • Fax: 870-741-8356
Mailing address:
  • Phone: 870-741-8343
  • Fax: 870-741-8356

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberN-8118
License Number StateAR

VIII. Authorized Official

Name: SHANNON I CORRIGAN
Title or Position: OFFICE MANAGER
Credential:
Phone: 870-741-8343