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General NPI Number Information
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NPI Number | 1770889552
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Entity Type | Organization
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Legal Business Name | ARKANSAS CHILDRENS HOSPITAL
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Dates
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Enumeration Date | 01/27/2011
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Last Update Date | 10/18/2018
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Provider Practice Location Address
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Address Line | 1 CHILDRENS WAY
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City | LITTLE ROCK
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State | AR
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Zip | 72202-3500
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Country | US
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Telephone | 501-364-2526
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Fax | 501-364-2438
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Provider Business Mailing Address
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Address Line | 1 CHILDRENS WAY
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City | LITTLE ROCK
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State | AR
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Zip | 72202-3500
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Country | US
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Telephone | 501-364-2526
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Fax | 501-364-2438
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MRS. CAROL M HUDGENS
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Credential |
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Telephone | 501-364-1079
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 3693
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 3693
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License Number State | AR
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Taxonomy #3
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 3693
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License Number State | AR
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Taxonomy #4
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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