Organization Name: | CONWAY UROLOGY, PA |
NPI Number: | 1255358263 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DAVID CRAIG SHIRLEY (OWNER) |
Mailing Address: | 495 Hogan Lane Suite 2 Conway |
State: | AR US |
Postal Code: | 72034 |
Phone Number: | 5013275850 |
Fax Number: | 5013274910 |
NPI Enumeration Date: | 07/16/2006 |
NPI Last Update Date: | 11/21/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | MC-1601 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | AR |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |