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General NPI Number Information
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NPI Number | 1174585061
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Entity Type | Organization
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Legal Business Name | NEUROLOGY ASSOCIATES OF NORTHEAST ARKANSAS PA
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Dates
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Enumeration Date | 04/05/2006
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Last Update Date | 07/06/2011
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Provider Practice Location Address
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Address Line | 1107 E MATTHEWS AVE SUITE 200
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City | JONESBORO
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State | AR
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Zip | 72401-4315
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Country | US
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Telephone | 870-931-4442
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Fax | 870-802-0205
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Provider Business Mailing Address
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Address Line | 1107 E MATTHEWS AVE SUITE 200
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City | JONESBORO
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State | AR
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Zip | 72401-4315
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Country | US
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Telephone | 870-931-4442
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Fax | 870-802-0205
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RON E SOUTH
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Credential | M.D.
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Telephone | 870-931-4442
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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