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General NPI Number Information
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NPI Number | 1639678022
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Entity Type | Organization
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Legal Business Name | CENTRAL ARKANSAS GASTROENTEROLOGY ANESTHESIA SERVICES, LLC
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Dates
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Enumeration Date | 02/12/2018
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Last Update Date | 05/04/2018
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Provider Practice Location Address
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Address Line | 212 NATURAL RESOURCES DR
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City | LITTLE ROCK
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State | AR
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Zip | 72205-1573
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Country | US
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Telephone | 501-664-7200
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Fax | 501-664-7205
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Provider Business Mailing Address
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Address Line | 212 NATURAL RESOURCES DR
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City | LITTLE ROCK
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State | AR
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Zip | 72205-1573
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Country | US
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Telephone | 501-664-7200
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Fax | 501-664-7205
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Authorized Official
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Title or Position | OWNER
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Name | KEITH MORRIS
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Credential | MD
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Telephone | 501-664-7200
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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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