Healthcare Provider Details

I. General information

NPI: 1487624490
Provider Name (Legal Business Name): UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2422 N THOMPSON ST
SPRINGDALE AR
72764-1757
US

IV. Provider business mailing address

2422 N THOMPSON ST
SPRINGDALE AR
72764-1757
US

V. Phone/Fax

Practice location:
  • Phone: 479-750-6585
  • Fax: 479-750-6594
Mailing address:
  • Phone: 479-750-6585
  • Fax: 479-750-6594

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

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