Healthcare Provider Details

I. General information

NPI: 1467640946
Provider Name (Legal Business Name): ARKANSAS EM-I MEDICAL SERVICES, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2007
Last Update Date: 01/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 TYLER STREET
WEST MEMPHIS AR
72307
US

IV. Provider business mailing address

1717 MAIN ST #5200
DALLAS TX
75201-4612
US

V. Phone/Fax

Practice location:
  • Phone: 870-735-1500
  • Fax:
Mailing address:
  • Phone: 214-712-2000
  • Fax: 214-712-2444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: GREGORY JAMES BYRNE
Title or Position: PRESIDENT
Credential: MD
Phone: 214-712-2000