Basic Information
| Provider Information | |||||||||
| NPI: | 1497023360 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ARKANSAS ANESTHESIA ASSOCIATES, PLLC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1131 | ||||||||
| Address2: | |||||||||
| City: | SEAREY | ||||||||
| State: | AR | ||||||||
| PostalCode: | 721451131 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5017714693 | ||||||||
| FaxNumber: | 5017714885 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 MEDICAL PARK DR | ||||||||
| Address2: | |||||||||
| City: | BENTON | ||||||||
| State: | AR | ||||||||
| PostalCode: | 720153353 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5017714693 | ||||||||
| FaxNumber: | 5017714885 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/07/2011 | ||||||||
| LastUpdateDate: | 02/11/2020 | ||||||||
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| AuthorizedOfficialLastName: | MATHEWS | ||||||||
| AuthorizedOfficialFirstName: | BENJAMIN | ||||||||
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| AuthorizedOfficialTitleorPosition: | MANAGER/OWNER | ||||||||
| AuthorizedOfficialTelephone: | 5017714693 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
| NPICertificationDate: | 02/11/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | AR | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.