Organization Name:  MEDICAL ASSOCIATES OF NORTHWEST ARKANSAS, PA


Practice Location:
3344 N FUTRALL DR  FAYETTEVILLE, AR 72703 US
Tel: 479-521-8200  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

Primary	Code	Category/Description	State	License Number
N	2084N0400X	Physicians Psychiatry & Neurology Neurology
N	2084P0800X	Physicians Psychiatry & Neurology
N	2085R0202X	Physicians Radiology
N	207RG0100X	Physicians Internal Medicine
N	207RP1001X	Physicians Internal Medicine
N	207RR0500X	Physicians Internal Medicine
N	207RS0012X	Physicians Internal Medicine
N	207Q00000X	Physicians Family Medicine
N	207VG0400X	Physicians Obstetrics & Gynecology
Y	207R00000X	Physicians Internal Medicine

Other Provider Identifiers:

Issuer	Number	State	Type
AR BC/BS	56750	AR	01
	100726870A	OK	05
	155870002	AR	05

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin