Healthcare Provider Details

I. General information

NPI: 1063744472
Provider Name (Legal Business Name): HEMATOLOGY ONCOLOGY ASSOCIATES P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2010
Last Update Date: 05/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4310 S MULBERRY ST
PINE BLUFF AR
71603-7030
US

IV. Provider business mailing address

4310 S MULBERRY ST
PINE BLUFF AR
71603-7030
US

V. Phone/Fax

Practice location:
  • Phone: 870-534-1188
  • Fax: 870-534-0188
Mailing address:
  • Phone: 870-534-1188
  • Fax: 870-534-0188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberE4024
License Number StateAR

VIII. Authorized Official

Name: DR. ASIF MASOOD
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 870-534-1188