Healthcare Provider Details

I. General information

NPI: 1235192980
Provider Name (Legal Business Name): ARKANSAS HEALTH GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2006
Last Update Date: 05/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

904 AUTUMN RD SUITE 100
LITTLE ROCK AR
72211-3737
US

IV. Provider business mailing address

904 AUTUMN RD SUITE 100
LITTLE ROCK AR
72211-3737
US

V. Phone/Fax

Practice location:
  • Phone: 501-224-5437
  • Fax: 501-224-3473
Mailing address:
  • Phone: 501-224-5437
  • Fax: 501-224-3473

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number
License Number State

VIII. Authorized Official

Name: MRS. JANET BAILEY
Title or Position: CLINIC MANAGER
Credential:
Phone: 501-224-5437