Healthcare Provider Details
I. General information
NPI: 1386377083
Provider Name (Legal Business Name): URGENT TEAM OF ARKANSAS PHYSICIANS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/08/2022
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
411 FALLS BLVD S
WYNNE AR
72396-3501
US
IV. Provider business mailing address
30 BURTON HILLS BLVD STE 175
NASHVILLE TN
37215-6403
US
V. Phone/Fax
- Phone: 870-238-3261
- Fax: 870-238-3115
- Phone: 615-988-2009
- Fax: 615-250-9773
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QU0200X |
| Taxonomy | Urgent Care Clinic/Center |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR1300X |
| Taxonomy | Rural Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
STEPHANIE
HICKS
Title or Position: CONTROLLER
Credential:
Phone: 615-988-2004