Healthcare Provider Details

I. General information

NPI: 1952365256
Provider Name (Legal Business Name): ARKANSAS HEART HOSPITAL ANESTHESIA CONSULTANTS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2006
Last Update Date: 08/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 S SHACKLEFORD RD
LITTLE ROCK AR
72211-4335
US

IV. Provider business mailing address

PO BOX 95010
NORTH LITTLE ROCK AR
72190-5010
US

V. Phone/Fax

Practice location:
  • Phone: 501-219-7481
  • Fax:
Mailing address:
  • Phone: 501-771-4693
  • Fax: 501-771-4885

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: JON NEWSUM
Title or Position: PRESIDENT
Credential: MD
Phone: 501-771-4693