Provider Demographics
NPI:1689689440
Name:WILLIAM M FLURRY
Entity Type:Organization
Organization Name:WILLIAM M FLURRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWENER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:M
Authorized Official - Last Name:FLURRY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:501-565-3943
Mailing Address - Street 1:7301 BASELINE RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72209-4436
Mailing Address - Country:US
Mailing Address - Phone:501-565-3943
Mailing Address - Fax:
Practice Address - Street 1:7301 BASELINE RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72209-4436
Practice Address - Country:US
Practice Address - Phone:501-565-3943
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2252302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR614864OtherUNITED CONCORDIA
AR57815OtherARKANSAS BLUE CROSS