NEUROLOGY AND SLEEP DISORDER CENTER OF SOUTH ARKANSAS (NPI# 1417164559) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417164559 |
| Entity Type | Organization |
| Organization Name | NEUROLOGY AND SLEEP DISORDER CENTER OF SOUTH ARKANSAS |
| Practice Address |
300 Thompson Ave El Dorado AR 71730-4569 |
| Practice Telephone | 8708637399 |
| Practice Fax Number | 8708637292 |
| Mailing Telephone | 8708637399 |
| Mailing Fax Number | 8708637292 |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2008-04-24 |
| Authorized Official Name | SHAILESH C VORA (DOCTOR) |
| Authorized Official Telephone | 8708637399 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | R3612 | AR | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | BLUE CROSS BLUE SHIELD | 5F822 | 01 |
| Street Address |
300 THOMPSON AVE |
| City | EL DORADO |
| State | AR |
| Zip Code | 71730-4569 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184172579 | Ivory A. Kinslow, Mdpa | Ophthalmology | 300 Thompson Ave, El Dorado, AR 71730-4569 | 2016-09-14 |
| 1538478250 | South Arkansas Youth Services, Inc | Community/Behavioral Health | 300 Thompson Ave, El Dorado, AR 71730-4569 | 2010-09-29 |
| 1528384526 | Paula Webb | Counselor | 300 Thompson Ave, El Dorado, AR 71730-4569 | 2010-04-15 |
| 1225369895 | Lamont Anthony Fitts | Rehabilitation Practitioner | 300 Thompson Ave, El Dorado, AR 71730-4569 | 2010-01-21 |
| 1215268883 | Lisa Bridges | Case Manager/Care Coordinator | 300 Thompson Ave, El Dorado, AR 71730-4569 | 2010-01-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043856172 | Mental Health Counseling for Individuals and Couples | Clinic/Center | 3256 West Hillsboro Suite C, El Dorado, AR 71730 | 2019-11-25 |
| 1114578168 | Candance Marie Guinn | Nurse Practitioner | 1906 W Hillsboro St Ste B, El Dorado, AR 71730 | 2019-09-20 |
| 1811460462 | Kelsie Rogers | Pharmacist | 2202 N West Ave, El Dorado, El Dorado, AR 71730 | 2019-01-07 |
| 1861925331 | Kasey Leigh Mcclain | Nurse Practitioner | 2280 E Main St, El Dorado, AR 71730 | 2017-04-11 |
| 1366989568 | Shane Morr | Marriage & Family Therapist | 704 W 5th Dr, El Dorado, AR 71730 | 2017-01-25 |
| 1376986539 | Ivory A. Kinslow, Mdpa | Optometrist | 443 W Oak St, El Dorado, AR 71730 | 2013-04-08 |
| 1134485170 | Drs Weddle and Baumsardner | Dentist | 106 West Main St. 212, El Dorado, AR 71730 | 2012-04-04 |
| 1972888923 | Lenora S Newsome | Pharmacist | 2135 North West Ave, El Dorado, AR 71730 | 2011-10-20 |
| 1730460338 | South Arkansas Pharmacy, Inc | Pharmacy | 600 South Timberlane #101, El Dorado, AR 71730 | 2011-09-09 |
| 1710273891 | Ezinne Charity Nwude | Emergency Medicine | 701 N. West Avenue, El Dorado, AR 71730 | 2011-06-27 |
| Find all providers in zip 71730 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| 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. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659594521 | Ross Lowery | Specialist | 702 E 6th St, El Dorado, AR 71730-4012 | 2007-04-10 |
| 1295849495 | John J Jucas | Specialist | 525 W Faulkner St, El Dorado, AR 71730-4518 | 2006-08-18 |
| 1871580704 | Richard Edward Dietzen | Specialist | 403 W Oak St, Suite 302, El Dorado, AR 71730-4586 | 2005-10-05 |
| 1396732335 | Charles D Daniels | Specialist | 2700 Vine St, El Dorado, AR 71730-6700 | 2005-10-04 |
| 1548599988 | Interventional and Diagnostic Radiology of South Arkansas, P.a. | Specialist | 700 W Grove St, El Dorado, AR 71730-4416 | 2009-12-14 |
| 1114174893 | Womens Health Butler County P.a. | Specialist | 700 W Central Ave, Suite 412, El Dorado, KS 67042-2184 | 2008-08-25 |
| 1639348725 | Laura Lea Stevens | Specialist | 2700 Vine St, El Dorado, AR 71730-6700 | 2008-02-22 |
| 1598978801 | South Ar Surgical Clinic of El Dorado, Inc | Specialist | 815 Thompson Ave, El Dorado, AR 71730-4464 | 2007-05-07 |
| 1265654727 | Sarah Saffold | Specialist | 2700 Vine St, El Dorado, AR 71730-6700 | 2007-05-03 |
| 1952471849 | Radiology Associates of El Dorado Pllc | Specialist | 700 W Grove St, El Dorado, AR 71730-4416 | 2006-11-08 |
| Find all providers in EL DORADO | ||||
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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.