Healthcare Provider Details

I. General information

NPI: 1073531950
Provider Name (Legal Business Name): NORTHWEST ARKANSAS HOSPITALS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 08/23/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2422 N THOMPSON ST SUITE 104
SPRINGDALE AR
72764-1757
US

IV. Provider business mailing address

PO BOX 840448
DALLAS TX
75284-0448
US

V. Phone/Fax

Practice location:
  • Phone: 479-757-4000
  • Fax: 479-757-2908
Mailing address:
  • Phone: 479-757-4000
  • Fax: 479-757-2908

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License NumberAR4353
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberAR353
License Number StateAR
# 3
Primary TaxonomyN
Taxonomy Code364SG0600X
TaxonomyGerontology Clinical Nurse Specialist
License NumberAR4353
License Number StateAR
# 4
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberAR4353
License Number StateAR
# 5
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAR4353
License Number StateAR
# 6
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberAR4353
License Number StateAR

VIII. Authorized Official

Name: REBECCA HURLEY
Title or Position: SENIOR VICE PRESIDENT
Credential:
Phone: 214-473-3993