| Conway Neurology Pa | |
|
400 Salem Rd Bldg 3 Suite 1 Conway AR 72034-6162 | |
| (501) 505-0400 | |
| (501) 505-0402 |
| Full Name | Conway Neurology Pa |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 400 Salem Rd, Conway, Arkansas |
| Authorized Official Name and Position | David O Oberlander (OWNER) |
| Authorized Official Contact | 5015050400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Conway Neurology Pa Po Box 11078 Conway AR 72034-0019 Ph: (501) 860-6130 | Conway Neurology Pa 400 Salem Rd Bldg 3 Suite 1 Conway AR 72034-6162 Ph: (501) 505-0400 |
| NPI Number | 1811072838 |
|---|---|
| Provider Enumeration Date | 10/26/2006 |
| Last Update Date | 06/17/2008 |
| Medicare PECOS PAC ID | 4880720713 |
|---|---|
| Medicare Enrollment ID | O20100414000236 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811072838 | NPI | - | NPPES |
| 134556002 | Medicaid | AR | |
| E0479 | Other | AR | ELECTRONIC SUBMITTER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | David A. Oberlander |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1790860716 PECOS PAC ID: 6709786395 Enrollment ID: I20040110000195 |
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