Healthcare Provider Details

I. General information

NPI: 1477510220
Provider Name (Legal Business Name): SALINE HEART GROUP, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 HWY 35 N SUITE 8
BENTON AR
72019-2351
US

IV. Provider business mailing address

1000 HWY 35 N STE 8 P.O. BOX 2860
BENTON AR
72019-2353
US

V. Phone/Fax

Practice location:
  • Phone: 501-315-4008
  • Fax: 501-315-3411
Mailing address:
  • Phone: 501-315-4008
  • Fax: 501-315-3411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateAR

VIII. Authorized Official

Name: MRS. JAMIE KRTICKA
Title or Position: OFFICE MANAGER
Credential:
Phone: 501-315-4008