Provider Demographics
NPI:1669938684
Name:NATURAL STATE INTEGRATIVE MEDICINE, P.A.
Entity type:Organization
Organization Name:NATURAL STATE INTEGRATIVE MEDICINE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE
Authorized Official - Prefix:DR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:DAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:501-224-1224
Mailing Address - Street 1:12911 CANTRELL RD STE 4
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-1710
Mailing Address - Country:US
Mailing Address - Phone:501-224-1224
Mailing Address - Fax:501-224-1230
Practice Address - Street 1:12911 CANTRELL RD STE 4
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72223-1710
Practice Address - Country:US
Practice Address - Phone:501-224-1224
Practice Address - Fax:501-224-1230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-14
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty