Healthcare Provider Details
I. General information
NPI: 1700640984
Provider Name (Legal Business Name): COMPASS HEALTH SYSTEMS OF ARKANSAS INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/08/2024
Last Update Date: 02/08/2024
Certification Date: 02/08/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2255 STURGIS RD
CONWAY AR
72034-8029
US
IV. Provider business mailing address
1065 NE 125TH ST STE 300
NORTH MIAMI FL
33161-5833
US
V. Phone/Fax
- Phone: 888-852-6672
- Fax: 305-891-4228
- Phone: 888-852-6672
- Fax: 305-891-4228
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SCOTT
SEGAL
Title or Position: CEO
Credential: MD
Phone: 888-852-6672