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General NPI Number Information
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NPI Number | 1538267414
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Entity Type | Organization
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Legal Business Name | CLINICAL NEUROSCIENCE ASSOCIATES, INC.
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 01/02/2026
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Provider Practice Location Address
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Address Line | 320 N GREENWOOD AVE
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City | FORT SMITH
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State | AR
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Zip | 72901-3454
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Country | US
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Telephone | 479-434-2743
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Fax | 844-454-8351
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Provider Business Mailing Address
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Address Line | 7009 NAPLES WAY
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City | FORT SMITH
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State | AR
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Zip | 72916-8701
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Country | US
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Telephone | 479-434-2743
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Fax | 844-454-8351
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JON M GUSTAFSON
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Credential | MD
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Telephone | 479-434-2743
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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