Active NPI
Caroline Duos Mazoch, M.D.
- Pediatrics Physician
- Conway, AR
National Provider Identifier
1417248063
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- E-8647
- Practice address
- 2425 Dave Ward Dr Ste 601
Conway, AR 72034-8685 - Phone
- (501) 328-0055
- NPI assigned
- Apr 29, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | E-8647 | AR | Primary |
Addresses
Primary practice location
2425 Dave Ward Dr Ste 601
Conway, AR 72034-8685
Mailing address
2425 Dave Ward Dr Ste 601
Conway, AR 72034-8685
Phone (501) 328-0055
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E-8647 | AR | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1304035200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406592000000",
"number": "1417248063",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2425 DAVE WARD DR STE 601",
"city": "CONWAY",
"state": "AR",
"postal_code": "720348685",
"telephone_number": "501-328-0055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2425 DAVE WARD DR STE 601",
"city": "CONWAY",
"state": "AR",
"postal_code": "720348685",
"telephone_number": "501-328-0055"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAZOCH",
"first_name": "CAROLINE",
"middle_name": "DUOS",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-04-29",
"last_updated": "2014-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "AR",
"license": "E-8647",
"primary": true
}
],
"identifiers": [],
"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 Jul 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.