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General NPI Number Information
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NPI Number | 1144247644
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Entity Type | Organization
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Legal Business Name | NORTHWEST ARKANSAS ANESTHESIA ASSOCIATES
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 01/06/2011
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Provider Practice Location Address
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Address Line | 205 EAST JEFFERSON
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City | SILOAM SPRINGS
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State | AR
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Zip | 72761
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Country | US
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Telephone | 479-524-4141
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1251
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City | SILOAM SPRINGS
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State | AR
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Zip | 72761
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Country | US
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Telephone | 918-422-4102
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Fax | 918-422-4093
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Authorized Official
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Title or Position | ANESTHETIST CHIEF OF DEPARTMENT
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Name | DR. DANIEL HUNT COOPER
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Credential | MD
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Telephone | 918-422-4102
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | C8243
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License Number State | AR
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