Healthcare Provider Details

I. General information

NPI: 1588519680
Provider Name (Legal Business Name): ARKANSAS LIVER AND GASTROENTEROLOGY PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2026
Last Update Date: 03/03/2026
Certification Date: 03/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3215 OLD GREENWOOD ROAD SUITE A
FORT SMITH AR
72903-5375
US

IV. Provider business mailing address

3416 OLD GREENWOOD RD
FORT SMITH AR
72903-5462
US

V. Phone/Fax

Practice location:
  • Phone: 479-242-2888
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: SARAH COLUCCINO
Title or Position: MANAGER
Credential:
Phone: 479-242-2888