Healthcare Provider Details

I. General information

NPI: 1083160899
Provider Name (Legal Business Name): BAPTIST HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2016
Last Update Date: 05/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 UNITED DR SUITE 220
CONWAY AR
72032-7826
US

IV. Provider business mailing address

9501 BAPTIST HEALTH DR STE 600
LITTLE ROCK AR
72205-6231
US

V. Phone/Fax

Practice location:
  • Phone: 501-227-7596
  • Fax: 501-227-7787
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: TROY WELLS
Title or Position: PRESIDENT
Credential:
Phone: 501-202-2080