Provider Demographics
NPI:1962652859
Name:SALINE WOMENS GROUP
Entity Type:Organization
Organization Name:SALINE WOMENS GROUP
Other - Org Name:BLYTHEVILLE WOMEN'S GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:E
Authorized Official - Last Name:DANIELS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:870-780-1363
Mailing Address - Street 1:1100 MEDICAL DR
Mailing Address - Street 2:
Mailing Address - City:BLYTHEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72315-1425
Mailing Address - Country:US
Mailing Address - Phone:870-780-1363
Mailing Address - Fax:870-780-1364
Practice Address - Street 1:1100 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:BLYTHEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72315-1425
Practice Address - Country:US
Practice Address - Phone:870-780-1363
Practice Address - Fax:870-780-1364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-26
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE4589207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty