| Ozarks Neurology | |
|
4083 N Shiloh Dr Ste 9 Fayetteville AR 72703-5201 | |
| (479) 439-1696 | |
| (479) 439-1998 |
| Full Name | Ozarks Neurology |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4083 N Shiloh Dr Ste 9, Fayetteville, Arkansas |
| Authorized Official Name and Position | Thresa Clemons (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 5013204818 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ozarks Neurology 4083 N Shiloh Dr Ste 9 Fayetteville AR 72703-5201 Ph: (479) 439-1696 | Ozarks Neurology 4083 N Shiloh Dr Ste 9 Fayetteville AR 72703-5201 Ph: (479) 439-1696 |
| NPI Number | 1821788530 |
|---|---|
| Provider Enumeration Date | 05/08/2023 |
| Last Update Date | 07/31/2023 |
| Certification Date | 07/24/2023 |
| Medicare PECOS PAC ID | 4082072632 |
|---|---|
| Medicare Enrollment ID | O20230614002120 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821788530 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Roger C Horan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1538101928 PECOS PAC ID: 1658361654 Enrollment ID: I20090623000197 |
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