MEDICARE: UROLOGY ASSOCIATES OF NW ARKANSAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

General Provider Information

NPI Number	:	1396935029
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UROLOGY ASSOCIATES OF NW ARKANSAS

Provider Business Mailing Address
First Line	:	2100 S 54TH ST
Second Line	:
City	:	ROGERS
State	:	AR
Zip	:	72758-8169
Country	:	US
Telephone Number	:	479-271-7007
Fax Number	:	479-271-7035

Provider Business Practice Location Address
First Line	:	2100 S 54TH ST
Second Line	:
City	:	ROGERS
State	:	AR
Zip	:	72758-8169
Country	:	US
Telephone Number	:	479-271-7007
Fax Number	:	479-271-7035

Authorized Official
Title or Position	:	PARTNER
Name	:	DR. ORLANDO F AGUILAR-GUZMAN
Credential	:	MD
Telephone Number	:	479-271-7077

Provider Enumeration Date	:	07/30/2007
Last Update Date	:	07/30/2007

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1497810139 — DR. MARK ALAN HEWETT M.D.
Practice Location Address:

2100 S 54TH ST
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72758-8169

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1518181767 — JOEL B. FANKHAUSER MD
Practice Location Address:

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