Provider Demographics
NPI:1013233147
Name:NEUROBESS PA
Entity Type:Organization
Organization Name:NEUROBESS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:RAYFIELD
Authorized Official - Last Name:BESS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:479-271-9607
Mailing Address - Street 1:9851 S VIEW DR
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72756-8174
Mailing Address - Country:US
Mailing Address - Phone:479-271-9607
Mailing Address - Fax:479-271-2133
Practice Address - Street 1:1000 S 52ND ST
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-8610
Practice Address - Country:US
Practice Address - Phone:479-271-9607
Practice Address - Fax:479-271-2133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-14
Last Update Date:2020-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE61682084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1063408243OtherINDIVIDUAL NPI NUMBER
AR182596002Medicaid
AR1013233147OtherGROUP NPI NUMBER