CONWAY OB-GYN CLINIC PA (NPI# 1235198045) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235198045 |
| Entity Type | Organization |
| Organization Name | CONWAY OB-GYN CLINIC PA |
| Practice Address |
2180 Ada Avenue Suite 300 Conway AR 72034-6135 |
| Practice Telephone | 5013276547 |
| Practice Fax Number | 5013279715 |
| Mailing Telephone | 5013276547 |
| Mailing Fax Number | 5013279715 |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2020-11-04 |
| Authorized Official Name | ROBIN CAROL FAGALA (PRACTICE MANAGER) |
| Authorized Official Telephone | 5013276547 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 115352002 | 05 |
| Street Address |
2180 ADA AVENUE SUITE 300 |
| City | CONWAY |
| State | AR |
| Zip Code | 72034-6135 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013988609 | Keitha Dewitt Holland | Obstetrics & Gynecology | 2180 Ada Avenue, Suite 300, Conway, AR 72034-7203 | 2006-01-31 |
| 1841636263 | Katy Mary Katherine Cox | Obstetrics & Gynecology | 2180 Ada Avenue, Suite 300, Conway, AR 72034-7203 | 2013-05-13 |
| 1124387238 | Lauren Nolen | Obstetrics & Gynecology | 2180 Ada Avenue, Suite 300, Conway, AR 72034-6135 | 2012-05-09 |
| 1285606020 | Phillip Thomas Gullic | Obstetrics & Gynecology | 2180 Ada Avenue, Suite 300, Conway, AR 72034-7203 | 2006-02-06 |
| 1336111665 | Andrew Axley Cole | Obstetrics & Gynecology | 2180 Ada Avenue, Suite 300, Conway, AR 72034-6135 | 2006-02-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013563758 | Shelby M Perez | Case Manager/Care Coordinator | 3240 Stermer Rd, Conway, AR 72034 | 2019-08-16 |
| 1467932772 | Faith J Parfait | Licensed Practical Nurse | 1352 Watkins St, Conway, AR 72034 | 2018-08-16 |
| 1043790611 | David Adam Steinfeld | Nurse Practitioner | 855 S German Ln Ste 1, Conway, AR 72034 | 2018-08-14 |
| 1245728484 | Conway Behavioral Health, LLC | Psychiatry & Neurology | 2255 Sturgis Rd, Conway, AR 72034 | 2018-04-24 |
| 1972007292 | Eldercare of Arkansas IIi, Inc. | Assisted Living Facility | 1306 S. Donaghey, Conway, AR 72034 | 2018-03-21 |
| 1528561404 | Kouhei Kobayashi | Specialist/Technologist | 2201 Moix Blvd., Apt. 908, Conway, AR 72034 | 2018-03-16 |
| 1780191015 | Sydnie Thessing | Nurse Practitioner | 605 Dave Ward Drive #105, Conway, AR 72034 | 2018-01-09 |
| 1508371865 | Ebony Latreace Charleston | Case Manager/Care Coordinator | 3240 Stermer Road, Conway, AR 72034 | 2017-12-08 |
| 1689190647 | Denise Annette Aikman | Dentist | 1210 Hogan Lane, Suite 200, Conway, AR 72034 | 2017-08-21 |
| 1134669138 | Hortons Orthotic Lab, Inc. | Prosthetic/Orthotic Supplier | 635 Dave Ward, Suite 103, Conway, AR 72034 | 2017-02-24 |
| Find all providers in zip 72034 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184233173 | Bryan D Fuller Md Pa | Obstetrics & Gynecology | 625 United Dr Ste 330, Conway, AR 72032-7828 | 2020-07-27 |
| 1538402839 | Kathleen Turek Dunn | Obstetrics & Gynecology | 2376 Cypress Cir Ste 200, Conway, SC 29526-8994 | 2013-04-04 |
| 1346501020 | Curtis James Boyd IIi | Obstetrics & Gynecology | 625 United Dr Ste 360, Conway, AR 72032 | 2012-05-30 |
| 1417247628 | Jessica Adams Pullen | Obstetrics & Gynecology | 625 United Dr Ste 420, Conway, AR 72032-7826 | 2011-04-10 |
| 1124225321 | Henry Augustine Gonzales | Obstetrics & Gynecology | 2376 Cypress Cir Ste 203, Conway, SC 29526-8994 | 2007-06-29 |
| 1912118944 | Joshua L. Ward | Obstetrics & Gynecology | 2200 Ada Ave., Suite 301, Conway, AR 72034-4986 | 2007-05-24 |
| 1093930885 | Reginald Forrest Daves | Obstetrics & Gynecology | 2345 Steep Landing Rd, Conway, SC 29526-7833 | 2007-04-16 |
| 1134167158 | Coastal Carolina Ob Gyn LLC | Obstetrics & Gynecology | 620 Singleton Ridge Rd, Conway, SC 29526-9154 | 2006-06-02 |
| 1902869696 | Terry B Levenson | Obstetrics & Gynecology | 8004 Myrtle Trace Dr, Conway, SC 29526-8945 | 2006-04-11 |
| 1427020882 | Carole Lynn Jackson | Obstetrics & Gynecology | 525 Western Avenue, Suite 303, Conway, AR 72034-6135 | 2006-02-01 |
| Find all providers in CONWAY | ||||
Please comment or provide details below to improve the information on CONWAY OB-GYN CLINIC PA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.