CORPORATE MD, PLLC (NPI# 1265440465) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265440465 |
| Entity Type | Organization |
| Organization Name | CORPORATE MD, PLLC |
| Practice Address |
505 Industrial Blvd Suite 3 Conway AR 72032-7825 |
| Mailing Address |
505 Dave Ward Drive Suite 3 Conway AR 72032-7825 |
| Practice Telephone | 5013285885 |
| Practice Fax Number | 5013285886 |
| Mailing Telephone | 5013285885 |
| Mailing Fax Number | 5013285886 |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | PHILLIP S STONE (OWNER) |
| Authorized Official Telephone | 5012086088 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QX0100X |
Clinic/Center Specialization: Occupational Medicine |
MC-2506 | AR | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | MEDICAL BOARD CERTIFICATE | MC-2506 | 01 |
| Street Address |
505 INDUSTRIAL BLVD SUITE 3 |
| City | CONWAY |
| State | AR |
| Zip Code | 72032-7825 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730789843 | Amelia S Lasater | Pharmacist | 1155 Hwy 65n, Conway, AR 72032 | 2020-10-28 |
| 1619584604 | Danyelle Durocher | Occupational Therapist | 1301 North Museum Rd, Conway, AR 72032 | 2020-09-24 |
| 1780222174 | Eric Herman Boxnick | Pharmacist | 101 West Oak Street, Conway, AR 72032 | 2019-12-16 |
| 1932746070 | Habilitation Center, LLC | Psychiatric Residential Treatment Facility | 161 Skunk Hollow Road, Conway, AR 72032 | 2019-12-09 |
| 1679051668 | Mary Elizabeth Black | Nurse Practitioner | 222 Dave Ward Drive, Conway, AR 72032 | 2018-08-01 |
| 1275035602 | Conway Dental Center Pllc | Dentist | 1600 E. Oak Street Suite B, Conway, AR 72032 | 2018-03-01 |
| 1750821625 | Luke Osborne | Physical Therapy Assistant | 1 Thomas Ln, Conway, AR 72032 | 2017-02-27 |
| 1639620099 | Sam's West, Inc. | Technician/Technologist | 1250 South Amity Rd, Conway, AR 72032 | 2016-10-20 |
| 1922559343 | Sam's West, Inc. | Durable Medical Equipment & Medical Supplies | 1250 Sourth Amity Rd, Conway, AR 72032 | 2016-10-20 |
| 1639629108 | Posture Store | Durable Medical Equipment & Medical Supplies | 3900 Dave Ward Dr., Suite 1900-130, Conway, AR 72032 | 2016-10-09 |
| Find all providers in zip 72032 | ||||
| Taxonomy Code | 261QX0100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Occupational Medicine |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497960355 | South Carolina Department of Health and Environmental Control | Clinic/Center | 2830 Oak St, Conway, SC 29526-4560 | 2007-05-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215398425 | Fort Smith Hand Therapy LLC | Clinic/Center | 6301 Highway 45, Suite G, Fort Smith, AR 72916-8851 | 2016-03-15 |
| 1285919597 | River Valley Occupational Health | Clinic/Center | 821 W 2nd Ct, Russellville, AR 72801-4939 | 2011-10-18 |
| 1093021289 | Cooper Hand Therapy Inc | Clinic/Center | 114 Dyer, Mountain Home, AR 72653 | 2010-08-25 |
| 1740607324 | Baptist Health | Clinic/Center | 6800 Lindsey Rd, Little Rock, AR 72206-3877 | 2014-03-21 |
| 1457772279 | Heather Lienhart | Clinic/Center | 908 N Reynolds Rd, Bryant, AR 72022-3034 | 2013-12-20 |
| 1336560150 | Eddy Marie Horton Ot | Clinic/Center | 502 S Highway 27, Marshall, AR 72650-7638 | 2013-12-20 |
| 1033545561 | Compliance & Screening Services LLC | Clinic/Center | 525 W Faulkner St, El Dorado, AR 71730 | 2013-09-16 |
| 1457496630 | Cooper Rehabilitation Center | Clinic/Center | 2919 E Matthews Ave, Suite C, Jonesboro, AR 72401-4499 | 2007-02-21 |
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| 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.