Provider Demographics
NPI:1235340274
Name:UNIVERSITY OF ARKANAS FOR MEDICAL SCIENCES
Entity Type:Organization
Organization Name:UNIVERSITY OF ARKANAS FOR MEDICAL SCIENCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROFESSOR, CHP AUDIOLOGY & SPEECH
Authorized Official - Prefix:DR
Authorized Official - First Name:AMYN
Authorized Official - Middle Name:M
Authorized Official - Last Name:AMLANI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:501-569-8902
Mailing Address - Street 1:2801 SOUTH UNIVERSITY
Mailing Address - Street 2:SUITE 600
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72204
Mailing Address - Country:US
Mailing Address - Phone:501-569-3156
Mailing Address - Fax:501-569-3157
Practice Address - Street 1:5820 ASHER AVE STE 600
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72204-7871
Practice Address - Country:US
Practice Address - Phone:501-569-3155
Practice Address - Fax:501-569-3157
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSITY OF ARKANAS FOR MEDICAL SCIENCES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-24
Last Update Date:2018-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR174400000X, 231H00000X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR118880270Medicaid
AR118880720Medicaid