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General NPI Number Information
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NPI Number | 1760718514
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Entity Type | Organization
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Legal Business Name | PREFERRED MEDICAL ASSOCIATES LLC
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Dates
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Enumeration Date | 10/29/2009
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Last Update Date | 09/01/2010
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Provider Practice Location Address
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Address Line | 40 PLAZA WAY SUITE 30
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City | MOUNTAIN HOME
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State | AR
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Zip | 72653-9265
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Country | US
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Telephone | 870-492-9000
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Fax | 870-492-9003
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Provider Business Mailing Address
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Address Line | PO BOX 2368
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City | MOUNTAIN HOME
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State | AR
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Zip | 72654-2368
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Country | US
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Telephone | 870-492-9000
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Fax | 870-492-9003
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Authorized Official
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Title or Position | OWNER
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Name | ADAM R WOZNIAK
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Credential | DO
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Telephone | 870-492-9000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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