Healthcare Provider Details

I. General information

NPI: 1497736508
Provider Name (Legal Business Name): NES ARKANSAS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

EAST MAIN & SOUTH 20TH STREET
VAN BUREN AR
72956
US

IV. Provider business mailing address

PO BOX 403234
ATLANTA GA
30384-3234
US

V. Phone/Fax

Practice location:
  • Phone: 479-474-3401
  • Fax:
Mailing address:
  • Phone: 800-377-8721
  • Fax: 304-523-2241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: VINCENT MORRA
Title or Position: PRESIDENT/CEO
Credential:
Phone: 800-377-8721