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General NPI Number Information
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NPI Number | 1770534703
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Entity Type | Organization
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Legal Business Name | MEDICAL ASSOCIATES OF NORTHWEST ARKANSAS PA
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Dates
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Enumeration Date | 05/15/2006
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Last Update Date | 05/09/2025
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Provider Practice Location Address
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Address Line | 688 E MILLSAP RD STE 101
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-3930
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Country | US
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Telephone | 479-582-3366
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Fax | 479-582-5843
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Provider Business Mailing Address
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Address Line | PO BOX 1523
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City | FAYETTEVILLE
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State | AR
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Zip | 72702-1523
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Country | US
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Telephone | 479-571-6038
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Fax | 479-582-0222
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Authorized Official
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Title or Position | CFO
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Name | TERRY HURT
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Credential |
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Telephone | 479-571-6780
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health 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 | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number |
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License Number State |
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