| Conway Regional Neuroscience Center | |
|
2200 Ada Ave Ste 302 Conway AR 72034-4985 | |
| (501) 932-0352 | |
| (501) 932-0354 |
| Full Name | Conway Regional Neuroscience Center |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2200 Ada Ave Ste 302, Conway, Arkansas |
| Authorized Official Name and Position | William Pack (CFO) |
| Authorized Official Contact | 5014502112 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Conway Regional Neuroscience Center Po Box 9662 Conway AR 72033-9662 Ph: (501) 852-1363 | Conway Regional Neuroscience Center 2200 Ada Ave Ste 302 Conway AR 72034-4985 Ph: (501) 932-0352 |
| NPI Number | 1255879656 |
|---|---|
| Provider Enumeration Date | 02/06/2017 |
| Last Update Date | 11/09/2023 |
| Certification Date | 11/09/2023 |
| Medicare PECOS PAC ID | 3173428414 |
|---|---|
| Medicare Enrollment ID | O20170403000499 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255879656 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Mark L Clark |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1306921853 PECOS PAC ID: 8527967298 Enrollment ID: I20040102000233 |
| Provider Name | Regan Gallaher |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1992721880 PECOS PAC ID: 8123018090 Enrollment ID: I20040513000575 |
| Provider Name | Keith Oliver Schluterman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1053318147 PECOS PAC ID: 8123018918 Enrollment ID: I20040513001467 |
| Provider Name | Timothy E. Freyaldenhoven |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1174520258 PECOS PAC ID: 2961464946 Enrollment ID: I20100306000331 |
| Provider Name | Elana C Russell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831589720 PECOS PAC ID: 2062726375 Enrollment ID: I20160829001399 |
Dayspring Behavioral Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1270 Bruce St, Conway, AR 72034 Phone: 501-336-0100 Fax: 501-336-0115 | |
An Embraced Life Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1422 Caldwell St, Suite H, Conway, AR 72034 Phone: 501-499-9231 Fax: 501-904-4373 | |
Catalyst Counseling, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 930 Wingate St Ste E2, Conway, AR 72034 Phone: 501-500-4114 Fax: 501-764-4555 | |
Community Service Inc. - Conway Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 818 N Creek Dr, Conway, AR 72032 Phone: 501-327-9788 Fax: 501-327-9843 | |
Wellnite Medical Group Pa Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2395 Prince St, Conway, AR 72034 Phone: 341-888-7637 | |
Therapy Assessment Center, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 317 Oak St Ste 3, Conway, AR 72032 Phone: 501-291-3091 Fax: 501-588-0484 | |
Lighted Path Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1124 Oak St, Suite 250, Conway, AR 72032 Phone: 804-592-1205 Fax: 866-388-8128 |