Provider Type Icon

INFECTIOUS DISEASE SPECIALISTS OF NORTHWEST ARKANSAS NPI 1558445080


NPI Information

NPI: 1558445080
Provider Name: INFECTIOUS DISEASE SPECIALISTS OF NORTHWEST ARKANSAS
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
4038 N REMINGTON DR STE 4
FAYETTEVILLE, AR
ZIP 72703
Phone: (479) 444-6522
Get Directions

INFECTIOUS DISEASE SPECIALISTS OF NORTHWEST ARKANSAS is a specialist in Fayetteville, AR. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. INFECTIOUS DISEASE SPECIALISTS OF NORTHWEST ARKANSAS NPI is 1558445080. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4038 N REMINGTON DR STE 4
FAYETTEVILLE, AR
ZIP 72703-314
Phone: (479) 444-6522
Fax: (479) 444-9426

The provider's authorized official is Stephen Hall Hennigan .
The authorized official title is Owner and has the following contact phone number (479) 444-6522.

The enumeration date for this NPI number is 10/24/2006 and was last updated on 4/8/2011.


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
1174400000XSpecialistE0104ARKANSASYes

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
15F046MEDICARE ID-TYPE UNSPECIFIEDARKANSAS
2125127001MEDICAIDARKANSAS
35F046OTHERARKANSASBLUE CROSS
4E93290MEDICARE UPINARKANSAS

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.