| Conway Regional Endocrinology And Diabetes Center | |
|
525 Western Ave Ste 305b Conway AR 72034-4982 | |
| (501) 205-4990 | |
| (501) 205-4993 |
| Full Name | Conway Regional Endocrinology And Diabetes Center |
|---|---|
| Speciality | Internal Medicine |
| Location | 525 Western Ave Ste 305b, Conway, Arkansas |
| Authorized Official Name and Position | William Pack (CFO) |
| Authorized Official Contact | 5014502112 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Conway Regional Endocrinology And Diabetes Center Po Box 9662 Conway AR 72033-9662 Ph: (501) 852-1363 | Conway Regional Endocrinology And Diabetes Center 525 Western Ave Ste 305b Conway AR 72034-4982 Ph: (501) 205-4990 |
| NPI Number | 1255095139 |
|---|---|
| Provider Enumeration Date | 10/26/2021 |
| Last Update Date | 11/09/2023 |
| Medicare PECOS PAC ID | 3173428414 |
|---|---|
| Medicare Enrollment ID | O20220224001121 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255095139 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (* (Not Available)) | Primary |
| Provider Name | Elizabeth Strack |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164845814 PECOS PAC ID: 3476785254 Enrollment ID: I20140409001485 |
| Provider Name | Hooman Motahari |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1073967048 PECOS PAC ID: 7315272572 Enrollment ID: I20210920001946 |
| Provider Name | Maria Javaid |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1679886618 PECOS PAC ID: 8921492521 Enrollment ID: I20220224001677 |
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