William L. McColgan, III, M.D., PA
Organization Active NPI Surgery Physician · Conway, AR
NPI 1306072269 · NPPES record last updated Jun 3, 2020
Key facts
- NPI
- 1306072269
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Surgery Physician 208600000X
- License
- E-5948 (AR)
- Legal business name
- WILLIAM L. MCCOLGAN, III, M.D., PA
- Practice address
- 2425 Dave Ward Dr Ste 201
Conway, AR 72034-8680 - Phone
- (501) 504-2737
- Fax
- (501) 504-2798
- NPI assigned
- Jun 5, 2009
- Organization subpart
- No
Authorized official
- Name
- Dr. William Lewis McColgan III, M.D.
- Title
- Owner
- Phone
- (501) 504-2737
Practitioners 11
-
Terence L Angtuaco, M.D.
-
Angelo G Coppola Jr., M.D.
-
Brian Hughes, MD
-
David P McElreath, D.O.
-
Dhaval H Patel, MD
-
Scott A Wofford, M.D.
-
Kenneth Coggins, M.D.
-
Johnny Jones III, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090701000211 | AR | Part B Supplier - Clinic/Group Practice | 6002967197 |
Receives reassigned benefits from 1 practitioner Practice locations: Little Rock, AR; Conway, AR |
National Provider Directory
Locations
2425 Dave Ward Dr
Ste 201
Conway, AR 72034
Phone (501) 504-2737
10915 N Rodney Parham Rd
Little Rock, AR 72212
Phone (501) 747-2828
10915 N Rodney Parham Rd
Ste B
Little Rock, AR 72212
Phone (501) 747-2828
2501 Crestwood Rd
Ste 102
North Little Rock, AR 72116
Phone (501) 747-2828
39 Duncan St
Warsaw, NY 14569
Phone (585) 786-0190
Interoperability endpoints
- https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.73349
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician |
208600000X | E-5948 | AR | Yes |
Addresses
Primary practice location
2425 Dave Ward Dr Ste 201
Conway, AR 72034-8680
Mailing address
2425 Dave Ward Dr Ste 201
Conway, AR 72034-8680
Phone (501) 504-2737
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 179822002 | Medicaid | AR |
Other names
- William L. McColgan III, MD, PA
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | lew.mccolgan@msc.directbygreenway.com |
Other providers in Conway, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 3, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.