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General NPI Number Information
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NPI Number | 1982931192
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Entity Type | Organization
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Legal Business Name | NORTH ARKANSAS SURGERY CLINIC
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Dates
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Enumeration Date | 11/09/2009
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Last Update Date | 11/09/2009
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Provider Practice Location Address
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Address Line | 715 W SHERMAN AVE SUITE B
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City | HARRISON
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State | AR
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Zip | 72601-2743
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Country | US
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Telephone | 870-741-8343
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Fax | 870-741-8356
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Provider Business Mailing Address
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Address Line | 715 W SHERMAN AVE SUITE B
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City | HARRISON
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State | AR
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Zip | 72601-2743
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Country | US
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Telephone | 870-741-8343
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Fax | 870-741-8356
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | SHANNON I CORRIGAN
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Credential |
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Telephone | 870-741-8343
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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 | N-8118
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License Number State | AR
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