Healthcare Provider Details
I. General information
NPI: 1386179000
Provider Name (Legal Business Name): ARKANSAS HEALTH GROUP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/01/2017
Last Update Date: 05/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9601 BAPTIST HEALTH DR
LITTLE ROCK AR
72205-6321
US
IV. Provider business mailing address
11001 EXECUTIVE CENTER DR SUITE 200
LITTLE ROCK AR
72211-4316
US
V. Phone/Fax
- Phone: 501-812-7587
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RH0002X |
| Taxonomy | Hospice and Palliative Medicine (Internal Medicine) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
WILL
RUSHER
Title or Position: CEO
Credential:
Phone: 501-812-7509