MEDICARE: ARKANSAS HEALTH GROUP

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1700337136
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARKANSAS HEALTH GROUP

Provider Business Mailing Address
First Line	:	11001 EXECUTIVE CENTER DR STE 200
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72211-4393
Country	:	US
Telephone Number	:	501-812-7215
Fax Number	:	501-812-7207

Provider Business Practice Location Address
First Line	:	20 BAPTIST HEALTH DR
Second Line	:
City	:	HEBER SPRINGS
State	:	AR
Zip	:	72543-8765
Country	:	US
Telephone Number	:	501-362-0500
Fax Number	:	501-362-0501

Authorized Official
Title or Position	:	CEO
Name	:	MR. WILL RUSHER
Credential	:
Telephone Number	:	501-812-7500

Provider Enumeration Date	:	10/20/2016
Last Update Date	:	04/11/2019

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