MEDICARE: CENTRAL ARKANSAS RADIATION THERAPY INSTITUTE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry		AR

General Provider Information

NPI Number	:	1225161995
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRAL ARKANSAS RADIATION THERAPY INSTITUTE

Provider Business Mailing Address
First Line	:	PO BOX 55050
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72215-5050
Country	:	US
Telephone Number	:	501-664-8573
Fax Number	:	501-296-3200

Provider Business Practice Location Address
First Line	:	4 SAINT VINCENT CIR
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72205-5402
Country	:	US
Telephone Number	:	501-664-8573
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	MR. DAN P SUMMERS
Credential	:
Telephone Number	:	501-664-8573

Provider Enumeration Date	:	03/13/2007
Last Update Date	:	08/22/2020

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