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General NPI Number Information
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NPI Number | 1295385359
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Entity Type | Organization
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Legal Business Name | ATLAS HEALTHCARE ASSOCIATES, LLC
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Dates
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Enumeration Date | 09/19/2019
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Last Update Date | 12/04/2023
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Provider Practice Location Address
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Address Line | 408 OFFICE PARK DR STE 2
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City | BRYANT
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State | AR
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Zip | 72022-7536
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Country | US
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Telephone | 501-539-6836
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Fax |
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Provider Business Mailing Address
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Address Line | 5407 HIGHWAY 5 N STE 6
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City | BRYANT
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State | AR
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Zip | 72022-7034
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Country | US
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Telephone | 501-943-8028
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. PETER W GURESKY
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Credential | MD
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Telephone | 501-943-8028
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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