Healthcare Provider Details

I. General information

NPI: 1003862848
Provider Name (Legal Business Name): ARKANSAS CARDIOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 12/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9501 BAPTIST HEALTH DR STE 600
LITTLE ROCK AR
72205-6225
US

IV. Provider business mailing address

PO BOX 3496
LITTLE ROCK AR
72203
US

V. Phone/Fax

Practice location:
  • Phone: 501-227-7596
  • Fax:
Mailing address:
  • Phone: 501-227-7596
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: JAMES MATTHEW HARDAGE
Title or Position: ADMINISTRATOR
Credential:
Phone: 501-227-7596