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General NPI Number Information
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NPI Number | 1265421861
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Entity Type | Organization
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Legal Business Name | CONWAY REGIONAL MEDICAL CENTER, INC
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Dates
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Enumeration Date | 10/17/2005
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 2526 HIGHWAY 65 S STE 201
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City | CLINTON
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State | AR
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Zip | 72031-6678
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Country | US
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Telephone | 501-745-4914
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Fax | 501-745-6374
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Provider Business Mailing Address
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Address Line | PO BOX 9662
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City | CONWAY
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State | AR
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Zip | 72033-9662
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Country | US
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Telephone | 501-852-1363
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Fax | 501-852-1364
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | MATTHEW TROUP
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Credential |
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Telephone | 501-450-2111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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