Healthcare Provider Details

I. General information

NPI: 1750533642
Provider Name (Legal Business Name): UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2008
Last Update Date: 10/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 MARSHALL ST # SLOT900
LITTLE ROCK AR
72202-3510
US

IV. Provider business mailing address

800 MARSHALL ST # SLOT900
LITTLE ROCK AR
72202-3510
US

V. Phone/Fax

Practice location:
  • Phone: 501-364-3620
  • Fax: 501-364-3994
Mailing address:
  • Phone: 501-364-3620
  • Fax: 501-364-3994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number503-C
License Number StateAR

VIII. Authorized Official

Name: OLAN A NUGENT
Title or Position: EXECUTIVE ASSOCIATE DEAN
Credential:
Phone: 501-686-8135