Provider Demographics
NPI:1013987361
Name:OB-GYN ASSOCIATES, LTD.
Entity Type:Organization
Organization Name:OB-GYN ASSOCIATES, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PATSY
Authorized Official - Middle Name:
Authorized Official - Last Name:FRASURE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-935-3990
Mailing Address - Street 1:800 S CHURCH ST
Mailing Address - Street 2:SUITE 302
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-4176
Mailing Address - Country:US
Mailing Address - Phone:870-935-3990
Mailing Address - Fax:870-935-0871
Practice Address - Street 1:800 S CHURCH ST
Practice Address - Street 2:SUITE 302
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-4176
Practice Address - Country:US
Practice Address - Phone:870-935-3990
Practice Address - Fax:870-935-0871
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-26
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR770099102OtherEDS BREASTCARE
AR101710002Medicaid
ARCE7125OtherRAILROAD MEDICARE
AR101710002Medicaid