Healthcare Provider Details

I. General information

NPI: 1194768721
Provider Name (Legal Business Name): NORTHWEST PHYSICIANS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4077 ELM SPRINGS RD STE 105
SPRINGDALE AR
72762-3703
US

IV. Provider business mailing address

7100 COMMERCE WAY SUITE 170
BRENTWOOD TN
37027-2829
US

V. Phone/Fax

Practice location:
  • Phone: 479-757-5301
  • Fax: 479-927-2211
Mailing address:
  • Phone: 615-465-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number State

VIII. Authorized Official

Name: KRISTINA MUSIC
Title or Position: DIRECTOR PROVIDER ENROLLMENT
Credential:
Phone: 877-892-9815