Healthcare Provider Details

I. General information

NPI: 1700311222
Provider Name (Legal Business Name): ARKANSAS HEALTH GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2017
Last Update Date: 09/20/2023
Certification Date: 09/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 UNITED DR STE 410
CONWAY AR
72032-7810
US

IV. Provider business mailing address

11001 EXCECUTIVE CENTER DRIVE 200
LITTLE ROCK AR
72211-4393
US

V. Phone/Fax

Practice location:
  • Phone: 501-358-6892
  • Fax: 501-358-6894
Mailing address:
  • Phone: 501-358-6892
  • Fax: 501-358-6894

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. WILL RUSHER
Title or Position: CEO
Credential:
Phone: 501-812-7503