Provider Demographics
NPI:1538808225
Name:UNITY HEALTH - NEWPORT
Entity type:Organization
Organization Name:UNITY HEALTH - NEWPORT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:CASSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:POOL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-278-8346
Mailing Address - Street 1:1117 MCLAIN ST STE 600
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:AR
Mailing Address - Zip Code:72112-3547
Mailing Address - Country:US
Mailing Address - Phone:870-523-6796
Mailing Address - Fax:870-523-8769
Practice Address - Street 1:1117 MCLAIN ST STE 600
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:AR
Practice Address - Zip Code:72112-3547
Practice Address - Country:US
Practice Address - Phone:870-523-6796
Practice Address - Fax:870-523-8769
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNITY HEALTH - NEWPORT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-06-01
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR288194002Medicaid