Healthcare Provider Details

I. General information

NPI: 1891733739
Provider Name (Legal Business Name): ARKANSAS ASTHMA & LUNG CENTERS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

431 W OAK ST
EL DORADO AR
71730-4566
US

IV. Provider business mailing address

4 BARBER CT
MAUMELLE AR
72113-6491
US

V. Phone/Fax

Practice location:
  • Phone: 870-864-9190
  • Fax: 870-864-9191
Mailing address:
  • Phone: 501-580-0458
  • Fax: 501-580-0458

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225B00000X
TaxonomyPulmonary Function Technologist
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN V DIAZ
Title or Position: DIRECTOR
Credential:
Phone: 501-580-0458