Healthcare Provider Details
I. General information
NPI: 1700337136
Provider Name (Legal Business Name): ARKANSAS HEALTH GROUP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/20/2016
Last Update Date: 04/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
20 BAPTIST HEALTH DR
HEBER SPRINGS AR
72543-8765
US
IV. Provider business mailing address
11001 EXECUTIVE CENTER DR STE 200
LITTLE ROCK AR
72211-4393
US
V. Phone/Fax
- Phone: 501-362-0500
- Fax: 501-362-0501
- Phone: 501-812-7215
- Fax: 501-812-7207
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
WILL
RUSHER
Title or Position: CEO
Credential:
Phone: 501-812-7500