Provider Demographics
NPI:1851347264
Name:NEWPORT RADIOLOGY CONSULTANTS PA
Entity Type:Organization
Organization Name:NEWPORT RADIOLOGY CONSULTANTS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MUFIZ
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHAUHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:870-523-6592
Mailing Address - Street 1:PO BOX 1270
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:AR
Mailing Address - Zip Code:72112-1270
Mailing Address - Country:US
Mailing Address - Phone:870-523-6592
Mailing Address - Fax:870-523-0137
Practice Address - Street 1:1205 MCLAIN ST
Practice Address - Street 2:DEPT. OF RADIOLOGY
Practice Address - City:NEWPORT
Practice Address - State:AR
Practice Address - Zip Code:72112-3533
Practice Address - Country:US
Practice Address - Phone:870-523-6592
Practice Address - Fax:870-523-0137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARNA2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARNO ID UNDER SSNOtherBCBSAR
AR1851347264OtherAR TUBERCULOSIS PROGRAM
ARNO ID UNDER INDIVIDUMedicaid
ARS03116OtherNOVASYS HEALTH
AR1241350OtherCIGNA
AR770064602OtherAR BREASTCARE PROGRAM
AR172345000OtherUS DEPT OF LABOR
ARNO ID UNDER INDIVIDUMedicaid
AR=========OtherTIN
AR1241350OtherCIGNA
AR=========OtherAMCO
AR=========OtherAMERICAN PPO