Provider Demographics
NPI:1083486781
Name:UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES
Entity Type:Organization
Organization Name:UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES
Other - Org Name:UAMS HEALTH PRIMARY CARE CENTER - EL DORADO
Other - Org Type:Other Name
Authorized Official - Title/Position:VICE CHANCELLOR-CHIEF FINANCIAL OFF
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-686-5670
Mailing Address - Street 1:1617 N WASHINGTON
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:AR
Mailing Address - Zip Code:71753-2046
Mailing Address - Country:US
Mailing Address - Phone:870-234-7676
Mailing Address - Fax:
Practice Address - Street 1:620 W GROVE ST STE 202
Practice Address - Street 2:
Practice Address - City:EL DORADO
Practice Address - State:AR
Practice Address - Zip Code:71730-4425
Practice Address - Country:US
Practice Address - Phone:870-234-7676
Practice Address - Fax:870-562-2560
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-10-25
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty