Provider Demographics
NPI:1114947652
Name:WESTERN ARKANSAS CENTER FOR WOMENS HEALTH
Entity Type:Organization
Organization Name:WESTERN ARKANSAS CENTER FOR WOMENS HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TINA
Authorized Official - Middle Name:L
Authorized Official - Last Name:STELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-785-2229
Mailing Address - Street 1:PO BOX 10930
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72917-0930
Mailing Address - Country:US
Mailing Address - Phone:479-785-2229
Mailing Address - Fax:479-478-6745
Practice Address - Street 1:3224 S 70TH ST
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-5050
Practice Address - Country:US
Practice Address - Phone:479-785-2229
Practice Address - Fax:479-478-6745
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC-6638207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARE09397Medicare UPIN
AR50448Medicare ID - Type Unspecified