Provider Demographics
NPI:1588625412
Name:SCHLUTERMAN NEUROLOGY, INC.
Entity Type:Organization
Organization Name:SCHLUTERMAN NEUROLOGY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:O
Authorized Official - Last Name:SCHLUTERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:501-932-0352
Mailing Address - Street 1:2200 ADA AVE
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-4986
Mailing Address - Country:US
Mailing Address - Phone:501-932-0352
Mailing Address - Fax:501-932-0354
Practice Address - Street 1:2200 ADA AVE
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-4985
Practice Address - Country:US
Practice Address - Phone:501-932-0352
Practice Address - Fax:501-932-0354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-30
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE3984204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARDE6357OtherMEDICARE RAILROAD
AR5F068Medicare PIN
ARI03047Medicare UPIN
AR5M861F068Medicare ID - Type Unspecified