Ahmed Yahya Al-Aizari, DO

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Conway, AR

NPI 1982408845 · NPPES record last updated Jun 25, 2025

Key facts

NPI
1982408845
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
1700 Altus St Ste 110
Conway, AR 72032-4299
Phone
(501) 852-1366
Fax
(501) 852-1367
NPI assigned
Apr 1, 2025
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20250708002262 AR Order and Referring Only - Internal Medicine
Practitioner - Internal Medicine
5597279034

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Osteopathy

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

1700 Altus St Ste 110
Conway, AR 72032-4299

Mailing address

PO Box 9662
Conway, AR 72033-9662
Phone (501) 852-1363

Other providers in Conway, AR

All providers in Conway, AR · Student in an Organized Health Care Education/Training Program in Arkansas

Sources for this page

Verify at the official NPI Registry.