Healthcare Provider Details

I. General information

NPI: 1932377769
Provider Name (Legal Business Name): ARKANSAS SPECIALTY CARE CENTERS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2008
Last Update Date: 01/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 S MCKINLEY ST SUITE 300
LITTLE ROCK AR
72205-5202
US

IV. Provider business mailing address

600 S MCKINLEY ST SUITE 300
LITTLE ROCK AR
72205-5202
US

V. Phone/Fax

Practice location:
  • Phone: 501-663-3647
  • Fax: 501-664-7113
Mailing address:
  • Phone: 501-663-3647
  • Fax: 501-664-7113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: KEN E BEASLEY
Title or Position: CEO
Credential:
Phone: 501-978-2600