Healthcare Provider Details

I. General information

NPI: 1013844745
Provider Name (Legal Business Name): UNITY HEALTH - JACKSONVILLE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 BRADEN ST
JACKSONVILLE AR
72076-3721
US

IV. Provider business mailing address

1400 BRADEN ST
JACKSONVILLE AR
72076-3721
US

V. Phone/Fax

Practice location:
  • Phone: 501-453-5000
  • Fax:
Mailing address:
  • Phone: 501-453-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: LAURA GILLENWATER
Title or Position: CFO/VP TREASURER
Credential:
Phone: 501-380-1010