Provider Demographics
NPI:1063744472
Name:HEMATOLOGY ONCOLOGY ASSOCIATES P.A.
Entity type:Organization
Organization Name:HEMATOLOGY ONCOLOGY ASSOCIATES P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ASIF
Authorized Official - Middle Name:
Authorized Official - Last Name:MASOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:870-534-1188
Mailing Address - Street 1:4310 S MULBERRY ST
Mailing Address - Street 2:
Mailing Address - City:PINE BLUFF
Mailing Address - State:AR
Mailing Address - Zip Code:71603-7030
Mailing Address - Country:US
Mailing Address - Phone:870-534-1188
Mailing Address - Fax:870-534-0188
Practice Address - Street 1:4310 S MULBERRY ST
Practice Address - Street 2:
Practice Address - City:PINE BLUFF
Practice Address - State:AR
Practice Address - Zip Code:71603-7030
Practice Address - Country:US
Practice Address - Phone:870-534-1188
Practice Address - Fax:870-534-0188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-10
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE4024174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR186027002Medicaid
AR186027002Medicaid