Healthcare Provider Details

I. General information

NPI: 1720084429
Provider Name (Legal Business Name): ARKANSAS OPEN MRI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2929 LAKEWOOD VILLAGE DR
NORTH LITTLE ROCK AR
72116-8033
US

IV. Provider business mailing address

301 N SHACKLEFORD RD STE B4
LITTLE ROCK AR
72211-2882
US

V. Phone/Fax

Practice location:
  • Phone: 501-687-6736
  • Fax: 501-687-0219
Mailing address:
  • Phone: 501-312-9990
  • Fax: 501-312-9991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. DON BALLARD
Title or Position: CEO
Credential:
Phone: 303-252-4363