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General NPI Number Information
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NPI Number | 1184192635
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Entity Type | Organization
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Legal Business Name | ARKEACCESS
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Dates
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Enumeration Date | 11/02/2018
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Last Update Date | 11/02/2018
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Provider Practice Location Address
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Address Line | 3024 RED WOLF BLVD
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City | JONESBORO
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State | AR
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Zip | 72401-7415
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Country | US
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Telephone | 870-926-1198
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Fax |
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Provider Business Mailing Address
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Address Line | 2912 KING ST
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City | JONESBORO
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State | AR
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Zip | 72401-5321
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING
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Name | MYCA BARKER
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Credential |
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Telephone | 870-926-1198
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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