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General NPI Number Information
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NPI Number | 1619820701
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Entity Type | Organization
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Legal Business Name | NEW YORK INSTITUTE OF TECHNOLOGY
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Dates
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Enumeration Date | 02/18/2026
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Last Update Date | 02/18/2026
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Provider Practice Location Address
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Address Line | 406 SAINT FRANCIS ST
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City | MARKED TREE
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State | AR
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Zip | 72365-2241
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Country | US
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Telephone | 870-972-2054
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1380
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City | STATE UNIVERSITY
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State | AR
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Zip | 72467-1380
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DEAN OF NYITCOM-AR
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Name | SHANE SPEIGHTS
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Credential | DO
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Telephone | 870-680-8882
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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