Provider Demographics
NPI:1932285459
Name:ARKANSAS HEADACHE CLINIC
Entity Type:Organization
Organization Name:ARKANSAS HEADACHE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WANDAL
Authorized Official - Middle Name:D
Authorized Official - Last Name:MONEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:501-833-3833
Mailing Address - Street 1:2215 WILDWOOD
Mailing Address - Street 2:STE 105
Mailing Address - City:SHERWOOD
Mailing Address - State:AR
Mailing Address - Zip Code:72120
Mailing Address - Country:US
Mailing Address - Phone:501-833-3833
Mailing Address - Fax:501-833-8191
Practice Address - Street 1:2215 WILDWOOD
Practice Address - Street 2:STE 105
Practice Address - City:SHERWOOD
Practice Address - State:AR
Practice Address - Zip Code:72120
Practice Address - Country:US
Practice Address - Phone:501-833-3833
Practice Address - Fax:501-833-8191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARMC11932084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty