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General NPI Number Information
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NPI Number | 1679640148
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Entity Type | Organization
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Legal Business Name | ALLERGY & ASTHMA CLINIC OF NORTHWEST ARKANSAS
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 1900 S WALTON BLVD
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City | BENTONVILLE
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State | AR
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Zip | 72712-6755
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Country | US
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Telephone | 479-254-9777
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Fax | 201-849-7650
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Provider Business Mailing Address
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Address Line | 1900 S WALTON BLVD
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City | BENTONVILLE
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State | AR
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Zip | 72712-6755
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Country | US
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Telephone | 479-254-9777
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Fax | 201-849-7650
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TINA K MERRITT MEINHOLZ
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Credential | M.D.
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Telephone | 479-254-9777
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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 | E 2999
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License Number State | AR
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