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NORTHWEST ARKANSAS OB/GYN ASSOC.PLC NPI 1053344234


NPI Information

NPI: 1053344234
Provider Name: NORTHWEST ARKANSAS OB/GYN ASSOC.,PLC

Doing Business As: CREEKSIDE CENTER FOR WOMEN & LASER AESTHETICS

Classification: Obstetrics & Gynecology - 207V00000X
Entity Type: Organization

CLIA Number: 04D0704472

Address:
5330 WILLOW CREEK DR
SPRINGDALE, AR
ZIP 72762
Phone: (479) 582-9268
Get Directions

NORTHWEST ARKANSAS OB/GYN ASSOC.,PLC is an obstetrics gynecology in Springdale, AR. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. NORTHWEST ARKANSAS OB/GYN ASSOC.,PLC NPI is 1053344234. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Creekside Center For Women & Laser Aesthetics.

The provider's business location address is:

5330 WILLOW CREEK DR
SPRINGDALE, AR
ZIP 72762-702
Phone: (479) 582-9268
Fax: (479) 973-9229

The provider's authorized official is Kent A Mason .
The authorized official title is Partner and has the following contact phone number (479) 582-9268.

The CLIA number assigned to this NPI record is 04D0704472 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 7/9/2006 and was last updated on 11/8/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207V00000XObstetrics & GynecologyMC1823ARKANSASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
15B762MEDICARE ID-TYPE UNSPECIFIEDARKANSAS
2134004002MEDICAIDARKANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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