Healthcare Provider Details

I. General information

NPI: 1750331492
Provider Name (Legal Business Name): MEDICAL ASSOCIATES OF NORTHWEST ARKANSAS, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1109 S WEST END ST
SPRINGDALE AR
72764-5228
US

IV. Provider business mailing address

PO BOX 1523
FAYETTEVILLE AR
72702-1523
US

V. Phone/Fax

Practice location:
  • Phone: 479-750-3630
  • Fax: 479-751-3308
Mailing address:
  • Phone: 479-750-3630
  • Fax: 479-751-3308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: TERRY HURT
Title or Position: CFO
Credential:
Phone: 479-571-6780