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NPI Code Detail

MEDICARE: SALINE PHYSICIAN SERVICES, LLC

MEDICARE: SALINE PHYSICIAN SERVICES, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology Physician

General Provider Information

NPI Number : 1427351865
Entity Type Code : Organization
Provider Name (Legal Business Name) : SALINE PHYSICIAN SERVICES, LLC
Provider Business Mailing Address
First Line : PO BOX 2577
Second Line :
City : BENTON
State : AR
Zip : 72018-2577
Country : US
Telephone Number : 501-778-0427
Fax Number : 501-778-5993
Provider Business Practice Location Address
First Line : 910 N EAST ST
Second Line :
City : BENTON
State : AR
Zip : 72015-3327
Country : US
Telephone Number : 501-778-0427
Fax Number : 501-778-5993
Authorized Official
Title or Position : DIRECTOR, PHYSICIAN SERVICES
Name : KIMBERLY A TITSWORTH
Credential :
Telephone Number : 501-776-6093
Provider Enumeration Date : 12/07/2010
Last Update Date : 03/29/2011

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Directions to “SALINE PHYSICIAN SERVICES, LLC ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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