Organization Active NPI

Corporate MD, PLLC

  • Occupational Medicine Clinic/Center
  • Conway, AR
National Provider Identifier
1265440465
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine Clinic/CenterTaxonomy code 261QX0100X
License
MC-2506 Issued in AR
Legal business name
CORPORATE MD, PLLC
Practice address
505 Industrial Blvd
Suite 3
Conway, AR 72032-7825
Phone
(501) 328-5885
Fax
(501) 328-5886
NPI assigned
Aug 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Phillip S Stone, MD
Title
Owner
Phone
(501) 208-6088

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Medicine Clinic/Center 261QX0100X MC-2506 AR Primary

Addresses

Primary practice location

505 Industrial Blvd
Suite 3
Conway, AR 72032-7825

Mailing address

505 Dave Ward Drive
Suite 3
Conway, AR 72032-7825
Phone (501) 328-5885

Other identifiers 1

IdentifierTypeStateIssuer
MC-2506OtherARMEDICAL BOARD CERTIFICATE

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265440465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 DAVE WARD DRIVE",
            "address_2": "SUITE 3",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720327825",
            "telephone_number": "501-328-5885",
            "fax_number": "501-328-5886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 INDUSTRIAL BLVD",
            "address_2": "SUITE 3",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720327825",
            "telephone_number": "501-328-5885",
            "fax_number": "501-328-5886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORPORATE MD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STONE",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "501-208-6088",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": "AR",
            "license": "MC-2506",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL BOARD CERTIFICATE",
            "identifier": "MC-2506",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.