Healthcare Provider Details

I. General information

NPI: 1730819145
Provider Name (Legal Business Name): ARKANSAS RHEUMATOLOGY INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2022
Last Update Date: 03/23/2023
Certification Date: 03/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 S UNIVERSITY AVE
LITTLE ROCK AR
72205-5302
US

IV. Provider business mailing address

500 S UNIVERSITY AVE STE 815
LITTLE ROCK AR
72205-5310
US

V. Phone/Fax

Practice location:
  • Phone: 501-747-1064
  • Fax: 501-747-1087
Mailing address:
  • Phone: 501-747-1064
  • Fax: 501-747-1087

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: LINDA LONG
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 501-223-2776