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General NPI Number Information
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NPI Number | 1609814185
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Entity Type | Organization
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Legal Business Name | AMERIS OF ARKANSAS
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Dates
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Enumeration Date | 06/04/2006
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 1100 MEDICAL DRIVE
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City | BLYTHEVILLE
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State | AR
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Zip | 72315
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Country | US
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Telephone | 870-762-6725
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Fax | 870-762-8125
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Provider Business Mailing Address
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Address Line | 1520 N DIVISION ST
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City | BLYTHEVILLE
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State | AR
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Zip | 72315-1448
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Country | US
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Telephone | 870-762-6725
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Fax | 870-762-8125
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Authorized Official
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Title or Position | DIRECTOR
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Name | DENIS WELLINGTON MILLER
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Credential |
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Telephone | 870-762-1190
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #4
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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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