DEFY AGE MED SPA PLLC NPI 1407515141

NPI Information

  • NPI: 1407515141
  • Provider Name: DEFY AGE MED SPA, PLLC
  • Classification: Anesthesiology - 207LP2900X
  • Specialization: Pain Medicine
  • Entity Type: Organization
  • Address: 2501 DAVE WARD DR STE A17
    CONWAY, AR
    ZIP 72034
  • Phone: (501) 499-9252

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NPI Details

DEFY AGE MED SPA, PLLC is a pain medicine anesthesiology in Conway, AR. The provider is an anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. DEFY AGE MED SPA, PLLC NPI is 1407515141. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2501 DAVE WARD DR STE A17
CONWAY, AR
ZIP 72034-090
Phone: (501) 499-9252

The provider's authorized official is Heather Whaley .
The authorized official title is Owner and has the following contact phone number (501) 554-6005.

The enumeration date for this NPI number is 12/9/2021 and was last updated on 12/9/2021.

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
1207LP2900XAnesthesiologyPain MedicineYes

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: 11/21/2025

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