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MEDICAL ASSOCIATES OF NORTHWEST ARKANSAS NPI 1386695427


NPI Information

NPI: 1386695427
Provider Name: MEDICAL ASSOCIATES OF NORTHWEST ARKANSAS

Other Name: NORTHWEST ARKANSAS PEDIATRIC CLINIC

Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 04D0936597

Address:
3380 N FUTRALL DR STE 1
FAYETTEVILLE, AR
ZIP 72703
Phone: (479) 442-7322
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MEDICAL ASSOCIATES OF NORTHWEST ARKANSAS is a pediatrics in Fayetteville, AR. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. MEDICAL ASSOCIATES OF NORTHWEST ARKANSAS NPI is 1386695427. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Northwest Arkansas Pediatric Clinic.

The provider's business location address is:

3380 N FUTRALL DR STE 1
FAYETTEVILLE, AR
ZIP 72703-815
Phone: (479) 442-7322
Fax: (479) 442-7379

The provider's authorized official is John Jordin .
The authorized official title is Vp Business Operations and has the following contact phone number (479) 571-6780.

The CLIA number assigned to this NPI record is 04D0936597 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/13/2006 and was last updated on 6/12/2019.


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
1208000000XPediatricsYes

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
1100726870BMEDICAIDOKLAHOMA
2155663002MEDICAIDARKANSAS
357547OTHERARKANSASAR BC/BS

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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