Provider Demographics
NPI:1841422532
Name:COMPASSION WOMEN'S CLINIC PA
Entity Type:Organization
Organization Name:COMPASSION WOMEN'S CLINIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:CAROZZA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:870-403-0299
Mailing Address - Street 1:2915 CYPRESS RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:ARKADELPHIA
Mailing Address - State:AR
Mailing Address - Zip Code:71923-4228
Mailing Address - Country:US
Mailing Address - Phone:870-403-0299
Mailing Address - Fax:
Practice Address - Street 1:2915 CYPRESS RD
Practice Address - Street 2:SUITE A
Practice Address - City:ARKADELPHIA
Practice Address - State:AR
Practice Address - Zip Code:71923-4228
Practice Address - Country:US
Practice Address - Phone:870-403-0299
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-14
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-4141207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR179182002Medicaid
AR771101902OtherBREASTCARE
AR5G334Medicare PIN