Provider Demographics
NPI:1497023360
Name:ARKANSAS ANESTHESIA ASSOCIATES, PLLC.
Entity Type:Organization
Organization Name:ARKANSAS ANESTHESIA ASSOCIATES, PLLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MATHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:501-771-4693
Mailing Address - Street 1:PO BOX 1131
Mailing Address - Street 2:
Mailing Address - City:SEAREY
Mailing Address - State:AR
Mailing Address - Zip Code:72145-1131
Mailing Address - Country:US
Mailing Address - Phone:501-771-4693
Mailing Address - Fax:501-771-4885
Practice Address - Street 1:1 MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:AR
Practice Address - Zip Code:72015-3353
Practice Address - Country:US
Practice Address - Phone:501-771-4693
Practice Address - Fax:501-771-4885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-07
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty