MEDICARE: ARKANSAS MRI 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
1	261QR0200X	Radiology Clinic/Center	0200795	AR

General Provider Information

NPI Number	:	1710939269
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARKANSAS MRI SERVICES, LLC

Provider Business Mailing Address
First Line	:	361 E MILLSAP RD
Second Line	:
City	:	FAYETTEVILLE
State	:	AR
Zip	:	72703-6289
Country	:	US
Telephone Number	:	479-442-7740
Fax Number	:	479-442-9622

Provider Business Practice Location Address
First Line	:	361 E MILLSAP RD
Second Line	:
City	:	FAYETTEVILLE
State	:	AR
Zip	:	72703-6289
Country	:	US
Telephone Number	:	479-442-7740
Fax Number	:	479-442-9622

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. THOMAS BROWN SR.
Credential	:
Telephone Number	:	479-442-7740

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	03/26/2009

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