Provider Demographics
NPI:1760058895
Name:UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCE
Entity Type:Organization
Organization Name:UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE CHANCELLOR-CHIEF FINANCIAL OFF
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:D
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-686-5670
Mailing Address - Street 1:2425 DAVE WARD DR STE 1101
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-8686
Mailing Address - Country:US
Mailing Address - Phone:501-932-7600
Mailing Address - Fax:501-932-7603
Practice Address - Street 1:2425 DAVE WARD DR STE 101
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-8679
Practice Address - Country:US
Practice Address - Phone:501-932-7600
Practice Address - Fax:501-932-7603
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-05-30
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty