Healthcare Provider Details

I. General information

NPI: 1871655050
Provider Name (Legal Business Name): UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 07/12/2023
Certification Date: 07/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 JACK STEPHENS DR
LITTLE ROCK AR
72205-5524
US

IV. Provider business mailing address

PO BOX 251420
LITTLE ROCK AR
72225-7101
US

V. Phone/Fax

Practice location:
  • Phone: 501-686-8000
  • Fax: 501-526-5148
Mailing address:
  • Phone: 501-686-8000
  • Fax: 501-526-5148

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: AMANDA GEORGE
Title or Position: VICE CHANCELLOR-CHIEF FINANCIAL OFF
Credential:
Phone: 501-686-5670