Healthcare Provider Details

I. General information

NPI: 1912915026
Provider Name (Legal Business Name): B & N CT IMAGING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9601 INTERSTATE 630 EXIT 7 MEDICAL TOWERS I, SUITE 106
LITTLE ROCK AR
72205-7202
US

IV. Provider business mailing address

904 AUTUMN RD 500
LITTLE ROCK AR
72211-3702
US

V. Phone/Fax

Practice location:
  • Phone: 501-202-1838
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. STACEY C HINES
Title or Position: DIRECTOR SOFTWARE SUPPORT/PATIENT A
Credential:
Phone: 501-202-4078