Provider Demographics
NPI: | 1568057453 |
---|---|
Name: | UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCE |
Entity type: | Organization |
Organization Name: | UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCE |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | VICE CHANCELLOR-CHIEF FINANCIAL OFF |
Authorized Official - Prefix: | |
Authorized Official - First Name: | AMANDA |
Authorized Official - Middle Name: | D |
Authorized Official - Last Name: | GEORGE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 501-686-5670 |
Mailing Address - Street 1: | 2601 GENE GEORGE BLVD |
Mailing Address - Street 2: | |
Mailing Address - City: | SPRINGDALE |
Mailing Address - State: | AR |
Mailing Address - Zip Code: | 72762-0845 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 479-725-6800 |
Mailing Address - Fax: | 479-725-6582 |
Practice Address - Street 1: | 2601 GENE GEORGE BLVD |
Practice Address - Street 2: | |
Practice Address - City: | SPRINGDALE |
Practice Address - State: | AR |
Practice Address - Zip Code: | 72762-0845 |
Practice Address - Country: | US |
Practice Address - Phone: | 479-725-6800 |
Practice Address - Fax: | 479-725-6582 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2021-03-03 |
Last Update Date: | 2021-03-03 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | Group - Multi-Specialty | |
No | 207K00000X | Allopathic & Osteopathic Physicians | Allergy & Immunology | Group - Multi-Specialty | |
No | 207L00000X | Allopathic & Osteopathic Physicians | Anesthesiology | Group - Multi-Specialty | |
No | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Group - Multi-Specialty | |
No | 207Y00000X | Allopathic & Osteopathic Physicians | Otolaryngology | Group - Multi-Specialty | |
No | 207ZC0006X | Allopathic & Osteopathic Physicians | Pathology | Clinical Pathology | Group - Multi-Specialty |
No | 2080P0205X | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Endocrinology | Group - Multi-Specialty |
No | 2080P0206X | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Gastroenterology | Group - Multi-Specialty |
No | 2080P0207X | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Hematology-Oncology | Group - Multi-Specialty |
No | 2080P0216X | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Rheumatology | Group - Multi-Specialty |
No | 2084P0804X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Child & Adolescent Psychiatry | Group - Multi-Specialty |
No | 2085R0202X | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | Group - Multi-Specialty |
No | 2086S0120X | Allopathic & Osteopathic Physicians | Surgery | Pediatric Surgery | Group - Multi-Specialty |
No | 2088P0231X | Allopathic & Osteopathic Physicians | Urology | Pediatric Urology | Group - Multi-Specialty |