MEDICARE: NEUROLOGY OF ARKANSAS PA

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	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1487067849
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEUROLOGY OF ARKANSAS PA

Provider Business Mailing Address
First Line	:	PO BOX 16563
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72231-6563
Country	:	US
Telephone Number	:	501-945-4710
Fax Number	:

Provider Business Practice Location Address
First Line	:	2400 CRESTWOOD RD
Second Line	:	SUITE 101
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72116-7067
Country	:	US
Telephone Number	:	501-945-4710
Fax Number	:

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	JULIA MARIE MCCOY
Credential	:	MD
Telephone Number	:	501-945-4710

Provider Enumeration Date	:	06/03/2014
Last Update Date	:	06/03/2014

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