Healthcare Provider Details

I. General information

NPI: 1275508681
Provider Name (Legal Business Name): ARKANSAS NEPHROLOGY SERVICES, LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2006
Last Update Date: 07/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 W GROVE ST
EL DORADO AR
71730-4414
US

IV. Provider business mailing address

115 WRIGHTS ST
HOT SPRINGS AR
71913-6240
US

V. Phone/Fax

Practice location:
  • Phone: 870-862-0801
  • Fax: 870-862-3687
Mailing address:
  • Phone: 870-862-0801
  • Fax: 870-862-3687

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. DONETTE LIGON
Title or Position: ADMINISTRATOR
Credential:
Phone: 501-624-6000