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1841530318 NPI number — SOUTH CENTRAL MEDICAL SERVICES PA

NPI Number: 1841530318
Health Care Provider/Practitioner: SOUTH CENTRAL MEDICAL SERVICES PA

Information about “1841530318” NPI (SOUTH CENTRAL MEDICAL SERVICES PA) exists in 1841530318 in HTML format HTML  |  1841530318 in plain Text format TXT  |  1841530318 in PDF (Portable Document Format) PDF  |  1841530318 in an XML format XML  formats.

NPI Number : 1841530318 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1841530318",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "SOUTH CENTRAL MEDICAL SERVICES PA",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "701 S 21ST ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "FORT SMITH",
    "MailingAddressStateName": "AR",
    "MailingAddressPostalCode": "72901-4001",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "501-551-3556",
    "MailingAddressFaxNumber": "800-861-7171",
    "FirstLinePracticeLocationAddress": "5212 VILLAGE PKWY",
    "SecondLinePracticeLocationAddress": "SUITE 2",
    "PracticeLocationAddressCityName": "ROGERS",
    "PracticeLocationAddressStateName": "AR",
    "PracticeLocationAddressPostalCode": "72758-8104",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "479-657-6888",
    "PracticeLocationAddressFaxNumber": "479-434-5572",
    "EnumerationDate": "02/21/2013",
    "LastUpdateDate": "03/16/2013",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "CARLSON",
    "AuthorizedOfficialFirstName": "CHESTER",
    "AuthorizedOfficialMiddleName": "L.",
    "AuthorizedOfficialTitle": "PRESIDENT",
    "AuthorizedOfficialNamePrefix": "DR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "D.O.",
    "AuthorizedOfficialTelephoneNumber": "501-551-3556",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "363LF0000X",
          "TaxonomyName": "Family Nurse Practitioner",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LA2200X",
          "TaxonomyName": "Adult Health Nurse Practitioner",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QP2300X",
          "TaxonomyName": "Primary Care Clinic/Center",
          "LicenseNumber": "MC-2949",
          "LicenseNumberStateCode": "AR",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207Q00000X",
          "TaxonomyName": "Family Medicine Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        }
      ]
    }
  }
}
                
            

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