Provider Demographics
NPI:1851620751
Name:NW PHYSICIANS, LLC.
Entity Type:Organization
Organization Name:NW PHYSICIANS, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:EDDIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-757-4008
Mailing Address - Street 1:PO BOX 1069
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:AR
Mailing Address - Zip Code:72745-1069
Mailing Address - Country:US
Mailing Address - Phone:479-756-9199
Mailing Address - Fax:479-750-0572
Practice Address - Street 1:4301 GREATHOUSE SPRINGS ROAD
Practice Address - Street 2:
Practice Address - City:JOHNSON
Practice Address - State:AR
Practice Address - Zip Code:72741
Practice Address - Country:US
Practice Address - Phone:479-684-3000
Practice Address - Fax:479-750-0572
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTHWEST ARKANSAS HOSPITALS, LLC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-12-24
Last Update Date:2009-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA03322 APN284300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital