| Conway Gastroenterology, PA | |
|
455 Hogan Ln Conway AR 72034-8201 | |
| (501) 513-0799 | |
| (501) 513-0798 |
| Full Name | Conway Gastroenterology, PA |
|---|---|
| Speciality | Internal Medicine - Gastroenterology |
| Location | 455 Hogan Ln, Conway, Arkansas |
| Authorized Official Name and Position | Kevin D Heath (PHYSICIAN) |
| Authorized Official Contact | 5015130799 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Conway Gastroenterology, PA Po Box 10780 Conway AR 72034-0013 Ph: (501) 513-0799 | Conway Gastroenterology, PA 455 Hogan Ln Conway AR 72034-8201 Ph: (501) 513-0799 |
| NPI Number | 1528065976 |
|---|---|
| Provider Enumeration Date | 06/30/2005 |
| Last Update Date | 08/01/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528065976 | NPI | - | NPPES |
| 128136002 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | MC-1598 (Arkansas) | Primary |
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