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FORT NEURO NPI 1932619327


NPI Information

NPI: 1932619327
Provider Name: FORT NEURO
Classification: Neurological Surgery - 207T00000X
Entity Type: Organization

CLIA Number: 04D2140804

Address:
1501 S WALDRON RD STE 109
FORT SMITH, AR
ZIP 72903
Phone: (479) 242-3310
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FORT NEURO is a neurological surgery in Fort Smith, AR. The provider is a neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. FORT NEURO NPI is 1932619327. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1501 S WALDRON RD STE 109
FORT SMITH, AR
ZIP 72903-568
Phone: (479) 242-3310
Fax: (479) 439-8868

The provider's authorized official is Timothy Y Maryanov .
The authorized official title is Owner and has the following contact phone number (479) 242-3310.

The CLIA number assigned to this NPI record is 04D2140804 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/11/2017 and was last updated on 10/11/2017.


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
1208VP0014XPain MedicineInterventional Pain MedicineNo
2207T00000XNeurological SurgeryYes

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: 4/28/2024

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