Provider Demographics
NPI:1114228798
Name:OZARK EXPRESS CARE OF CONWAY, PLLC
Entity Type:Organization
Organization Name:OZARK EXPRESS CARE OF CONWAY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ASIF
Authorized Official - Middle Name:
Authorized Official - Last Name:MASSOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:870-489-1247
Mailing Address - Street 1:955 S DELAWARE AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65802-3319
Mailing Address - Country:US
Mailing Address - Phone:877-697-4696
Mailing Address - Fax:605-275-4009
Practice Address - Street 1:2350 VILLAGE COURT
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72032
Practice Address - Country:US
Practice Address - Phone:877-697-4696
Practice Address - Fax:605-275-4009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-12
Last Update Date:2010-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care