Healthcare Provider Details

I. General information

NPI: 1235816836
Provider Name (Legal Business Name): UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2023
Last Update Date: 11/17/2025
Certification Date: 11/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6119 MIDTOWN AVE
LITTLE ROCK AR
72205-5313
US

IV. Provider business mailing address

PO BOX 251420
LITTLE ROCK AR
72225-1420
US

V. Phone/Fax

Practice location:
  • Phone: 501-686-7000
  • Fax:
Mailing address:
  • Phone: 501-686-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

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