Healthcare Provider Details

I. General information

NPI: 1144268509
Provider Name (Legal Business Name): ARKANSAS HEALTH GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 05/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 S MAIN ST
SEARCY AR
72143-7319
US

IV. Provider business mailing address

11001 EXECUTIVE CENTER DR STE 200
LITTLE ROCK AR
72211-4316
US

V. Phone/Fax

Practice location:
  • Phone: 501-268-7143
  • Fax: 501-268-7198
Mailing address:
  • Phone: 501-812-7201
  • Fax: 501-812-7507

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. KIM TITSWORTH
Title or Position: CMA
Credential:
Phone: 501-812-7512