Healthcare Provider Details

I. General information

NPI: 1427151497
Provider Name (Legal Business Name): MINIMAL ACCESS SURGERY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 PHILLIPS PL
HUNTSVILLE AR
72740-6266
US

IV. Provider business mailing address

PO BOX 6220
SPRINGDALE AR
72766-6220
US

V. Phone/Fax

Practice location:
  • Phone: 479-738-1700
  • Fax:
Mailing address:
  • Phone: 479-738-1700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN H KENDRICK
Title or Position: PRESIDENT
Credential: MD
Phone: 479-738-1700