MEDICARE: ARKANSAS HEALTH GROUP

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207Q00000X	Family Medicine Physician
2	207R00000X	Internal Medicine Physician
3	363LW0102X	Women's Health Nurse Practitioner
4	363LX0001X	Obstetrics & Gynecology Nurse Practitioner
5	207VC0200X	Critical Care Medicine (Obstetrics & Gynecology) Physician
6	207VC0300X	Complex Family Planning Physician
7	207VG0400X	Gynecology Physician
8	207VM0101X	Maternal & Fetal Medicine Physician
9	207VX0000X	Obstetrics Physician
10	363L00000X	Nurse Practitioner
11	207V00000X	Obstetrics & Gynecology Physician

General Provider Information

NPI Number	:	1871324772
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARKANSAS HEALTH GROUP

Provider Business Mailing Address
First Line	:	11001 EXECUTIVE CENTER DR STE 200
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72211-4393
Country	:	US
Telephone Number	:	501-435-3455
Fax Number	:	501-483-3630

Provider Business Practice Location Address
First Line	:	4625 JOHN F KENNEDY BLVD
Second Line	:
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72116-7310
Country	:	US
Telephone Number	:	501-435-3455
Fax Number	:	501-438-3630

Authorized Official
Title or Position	:	CEO
Name	:	WILL L. RUSHER
Credential	:
Telephone Number	:	501-812-7215

Provider Enumeration Date	:	08/12/2024
Last Update Date	:	09/19/2024

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