CONWAY REGIONAL MEDICAL CENTER INC NPI 1245729359

NPI Information

  • NPI: 1245729359
  • Provider Name: CONWAY REGIONAL MEDICAL CENTER, INC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Doing Business As: CONWAY REGIONAL MEDICAL CLINIC-RUSSELLVILLE
  • CLIA Number: 04D0468970
  • Address: 108 SKYLINE DR
    RUSSELLVILLE, AR
    ZIP 72801
  • Phone: (479) 968-7170

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NPI Details

CONWAY REGIONAL MEDICAL CENTER, INC is a family medicine in Russellville, AR. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. CONWAY REGIONAL MEDICAL CENTER, INC NPI is 1245729359. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Conway Regional Medical Clinic-russellville.

The provider's business location address is:

108 SKYLINE DR
RUSSELLVILLE, AR
ZIP 72801-362
Phone: (479) 968-7170
Fax: (479) 968-7607

The provider's authorized official is William Pack .
The authorized official title is Cfo and has the following contact phone number (501) 450-2112.

The CLIA number assigned to this NPI record is 04D0468970 - rural health clinic with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 5/3/2018 and was last updated on 11/9/2023.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineARKANSASYes

What is NPI?

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This page was last updated on: 3/30/2025

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