1. Home
  2. Directory
  3. Arkansas
  4. Conway
  5. Dermatology
  6. NPI Profile

RUSSELL DERMATOLOGY OF CONWAY, PLLC
NPI 1639134067
Dermatology in Conway, AR

Active since April 19, 2006CLIA 04D0976193 · Microscopy
2425 DAVE WARD DR, SUITE 202, CONWAY, AR 72034(501) 328-5050(501) 328-2131 Get Directions Write a Review

NPPES record last updated: October 9, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Russell Dermatology Of Conway, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RUSSELL DERMATOLOGY OF CONWAY, PLLC (NPI 1639134067) is a healthcare organization registered as a dermatology in Conway, Arkansas and active in the NPI registry since April 2006. The organization holds a CLIA Microscopy certificate valid through August 10, 2027 and lists Jackie D Russell, Bus/office Mgr, as its authorized official.

NPPES Registry Identity

NPI1639134067
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameRUSSELL DERMATOLOGY OF CONWAY, PLLC
Location Address2425 DAVE WARD DR, SUITE 202Conway, AR 72034-8686
Mailing Address2425 Dave Ward Dr, Suite 202Conway, AR 72034-8686 · (501) 328-5050 · Fax (501) 328-2131
Phone(501) 328-5050
Fax(501) 328-2131
Organization SubpartNo
Authorized OfficialJackie D RussellBus/office Mgr · (501) 328-5050
Enumeration DateApril 19, 2006
Last NPPES UpdateOctober 9, 2025
NPPES CertifiedOctober 9, 2025
✔ NPI 1639134067 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in AR · E1574
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
2425 DAVE WARD DR, Conway, AR 72034
Open in Google Maps ↗

Other Identifiers 1

Medicaid140625002AZ

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 04D0976193

Russell Dermatology Of Conway PLLC · Conway, AR
Active · expires Aug 10, 2027
CLIA Number04D0976193
Laboratory TypePhysician Office
Certificate Effective DateAugust 11, 2025
Certificate Expiration DateAugust 10, 2027
Laboratory DirectorDr. Brian E. Russell
Laboratory Phone(501) 328-5050
Laboratory LocationRussell Dermatology Of Conway PLLC2425 Dave Ward Drive Suite 202, Conway, AR 72034
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DAVID WILLIAM SMITH P.D.
Pharmacist
2425 DAVE WARD DR, STE. 602
CONWAY, AR 72034
Faulkner County (501) 329-3777
DR. ERIC BRIAN RUSSELL M.D.
Dermatology
2425 DAVE WARD DR, SUITE 202
CONWAY, AR 72034
Faulkner County (501) 328-5050
JOE C CUMMINS MD
Family Medicine
2425 DAVE WARD DR, SUITE 401
CONWAY, AR 72034
Faulkner County (501) 329-3824
DR. LEAH MARIE LAMB
Pharmacist
2425 DAVE WARD DR, SUITE 602
CONWAY, AR 72034
Faulkner County (501) 329-3777
RANDAL G BOWLIN MD
Family Medicine
2425 DAVE WARD DR, STE 401
CONWAY, AR 72034
Faulkner County (501) 329-3824
PHARMACY OPERATIONS INC
Pharmacy (Community/Retail Pharmacy)
2425 DAVE WARD DR, SUITE 602
CONWAY, AR 72034
Faulkner County (501) 329-3777
DR. MATTHEW CLIFF BROWN AU.D.
Audiologist
2425 DAVE WARD DR
CONWAY, AR 72034
Faulkner County (501) 932-7600
DR. DAVID MICHAEL ARNOLD M.D.
Orthopaedic Surgery (Orthopaedic Surgery of the Spine)
2425 DAVE WARD DR, SUITE 201
CONWAY, AR 72034
Faulkner County (501) 329-7246

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Russell Dermatology Of Conway, PLLC's NPI number?

The NPI number for Russell Dermatology Of Conway, PLLC is 1639134067. It was assigned to this organization in the NPPES registry on April 19, 2006.

Where is Russell Dermatology Of Conway, PLLC located?

Russell Dermatology Of Conway, PLLC is located at 2425 Dave Ward Dr Suite 202, Conway, AR 72034. The listed phone number is (501) 328-5050.

What is Russell Dermatology Of Conway, PLLC's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Does Russell Dermatology Of Conway, PLLC hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 04D0976193) is associated with this NPI, valid through August 10, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Russell Dermatology Of Conway, PLLC accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and Ambetter from Superior HealthPlan and 2 other insurers list Russell Dermatology Of Conway, PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Russell Dermatology Of Conway, PLLC was last updated on October 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.