Healthcare Provider Details

I. General information

NPI: 1417246182
Provider Name (Legal Business Name): PLANNED PARENTHOOD OF ARKANSAS AND EASTERN OKLAHOMA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2011
Last Update Date: 08/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 E TOWNSHIP ST SUITE 1
FAYETTEVILLE AR
72703-2817
US

IV. Provider business mailing address

4401 W 109TH ST STE 200
LEAWOOD KS
66211-1303
US

V. Phone/Fax

Practice location:
  • Phone: 479-443-7971
  • Fax: 479-443-5761
Mailing address:
  • Phone: 918-587-1101
  • Fax: 918-592-7610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: VICTORIA PARKS
Title or Position: DIRECTOR OF HEALTH SERVICES OPS
Credential:
Phone: 918-587-4621